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Procedures for No Scalpel Vasectomy |
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Demonstration
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Keep in mind that there will be slight variations in no-scalpel
vasectomy (NSV) procedures amongst different physicians. The time taken to
perform the surgery ranges from 5 - 15 minutes.
When you arrive at the doctor's office or hospital you are taken into the
vasectomy procedure room. You lay down on the table, and the surgical assistant
cleans the scrotal area with iodine. The assistant then puts an elastic around
your penis and clips the elastic to your shirt to expose the scrotum. You are
then covered with a surgical drape and the scrotum is brought through an
opening.
2 Methods for
Freezing
The standard method is to inject a small amount of freezing solution into the
scrotal skin, then inject a little more freezing solution alongside each sperm
tube. This will cause a momentary dull ache, and after that you should not feel
anything.
Some doctors employ a modern method called no needle anesthetic (nna). This
is an air jet injector that delivers a spray of anesthetic under high pressure
through the skin. It is virtually painless and equally effective.
Virtually never are oral sedative medications required.
Once the area is frozen, the doctor locates the vas tubes one at a time. He
gently holds each vas tube between his fingertips, and grasps them with a
specially designed ringed clamp. With a pair of special forceps, he makes one
tiny puncture into the skin on the scrotum. This small incision "½"
(approximately 4 millimeters long), represents the true size of the puncture.
With the same instrument he gently lifts the first vas tube out through this
opening.
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Blocking of the Vas Tubes |
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How the the vas tubes are blocked differ among no-scalpel
vasectomy physicians. For example, once the vas tubes have been brought out
through the opening in the scrotum, some procedures involve just cutting and
tying the ends of the tube. Others cauterize (burn) the ends. Still others affix
metal clips to the ends. Combinations of any of these are possible. (different
methods described below)
Once the sperm tube (1.) is lifted out of the scrotum, it is cut and both
ends are blocked. (2.). A small section of the vas tube also may be removed at
this point. If the tubes are cauterized, the cauterization on the ends of the
tubes stimulates the formation of a strong scar that blocks the tubes.
Fascial Interposition
Some NSV doctors carry out an additional step (3.), that some studies suggest
increases the success of the procedure, called fascial interposition. This
step involves bringing the fascial sheath, or covering of the sperm tube, over
one end of the cut tube to create a natural barrier between the two cut ends.
Fascial interposition can be carried out using titanium clips or with a
dissolvable thread.
Open Vasectomy
Some studies suggest that when the tube is cut the testicular end should be
left open and that doing so may reduce the risk of post vasectomy pain. This
is called an open vasectomy.
The doctor then gently places the separated and blocked ends back in the scrotum, and the same procedure is done through the same small opening on the other sperm tube. The opening is finally covered with a gauze pad, and you can pull up your athletic support and clothes. The one small skin opening closes itself without stitches within days and heals almost without a trace.
The NSV procedure takes anywhere from 15 to 30 minutes, depending on your anatomy. After having something to drink and relaxing for a few minutes, most men have no trouble driving home on their own, but it is safer to have someone drive you home.
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