Keys to Microsurgical Vasectomy Reversal Success
When working with such tiny structures as the vas deferens, meticulous surgical technique is absolutely essential so that the two ends line up perfectly. This is to prevent excess scar tissue formation. Using the latest microsurgical techniques, 24 micro-sutures are carefully placed on each side to precisely line up the two ends of the vas deferens. The smallest micro-sutures used (in the inner layer of the repair) are 10-0 in size with a diameter of 0.02 mm (to compare, the diameter of a human hair is on average 0.04-0.12 mm). Obviously, an operating microscope is necessary to adequately visualize and work with these incredibly small sutures. When working under an operating microscope, any movement by the patient looks like an earthquake, so to perform the precision surgery needed for optimal outcomes, the patient must remain absolutely motionless for the entire procedure. The latest microsurgical techniques typically take an experienced microsurgeon about 2.5-3 hours to perform, a period of time for which it is not reasonable to expect someone to remain completely motionless if they are awake or under “twilight” sedation. Because of this, outpatient general anesthesia is almost always used.
It is very common for men to have some reservations and nervousness about going under general anesthesia. However, modern anesthesia techniques are very safe when performed under the careful monitoring of highly trained anesthesia providers, especially in otherwise healthy men. The benefits of using anesthesia during a reversal procedure are very important in that patient comfort during the procedure is not an issue (you wake up and it is done) and the performance of precision surgery is optimized, as the man remains completely motionless during his surgery.