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Vasectomy Procedures - Diagrams and Illustration

The key difference between the no-scalpel vasectomy and the conventional vasectomy procedures relates to how the vas tube is accessed.


Virtually never, are oral sedative medications required. There are two common techniques:

Needle Vasectomy Procedure

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.

The No Needle Vasectomy Procedure

The "No Needle Anesthesia" (nna) is a modern technique, accomplished by applying a pressurized jet spray to numb the area through a pen-like device, eliminating the need for a needle. The jet injector delivers a hypospray of Xylocaine under pressure instantly over each vas deferens.
This method has been use since about 2002. It has three main advantages for the patient:

  • It is considered virtually painless.
  • Requires about 1/50th less anesthetic
  • Length of time for anesthetic onset is reduced to 10-20 seconds
    from 60-90 seconds

The no-needle vasectomy (NNV) technique serves to reduce fear and anxiety prior to and during a vasectomy procedure, making it easier and faster for the surgeon.

Accessing the Vas Tube

The vas tube on one side is grasped under the scrotal skin. Then a 1cm incision is made through the scrotal skin and through the sheath or covering of the vas until the whole vas is exposed.

The vas is then grasped with a hand clamp, and the arteries, veins and nerves are dissected free at the vas tube. The vas tube is then elevated out of the scrotum and blocked one of the methods described below (same for in no-scalpel procedure) i.e., by tying, cauterizing or affixing metal clips the ends of the tubes. The wound is then often sutured closed. The same process is then repeated on the other side.

Vasectomy Procedure Diamgram 1 -

Blocking of the Vas Tubes

How the the vas tubes are blocked differ among vasectomy doctors. 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.

Vasectomy Procedure Diamgram of vas deferens sperm tube -

Vasectomy Procedure Diamgram of vas deferens ends cut & cauterized -

Fascial Interposition

Some NSV doctors carry out an additional step during the vasectomy procedure called fascial interposition. Some studies suggest it increases the success of the procedure. It 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.

Vasectomy Procedure Diamgram  - vas deferens fascial sheath tied around one end of cut tube

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.

Vasectomy diagram picture - vas deferens testicular tube left open

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