Our operating room set-up with microscope and high definition video tower
High-powered operating room microscope draped for surgery
Through a small opening in the upper scrotum, the vas deferens is identified. This image is magnified significantly, and the incision is actually less than one inch long. In this picture, the vas is being held with clamps above and below an area of scar tissue that has developed as a result of prior vasectomy.
The vas has been dissected free of the scar tissue. Note the narrowed area between the clamps. This is the location where the vas was divided at the time of vasectomy.
The vas has been cut with a microscopic knife on both sides of the vasectomy site to leave two clean, healthy edges. The lumen that needs to be reconnected looks like a small red dot at the center of the two ends of the vas.
10-0 micro-sutures have been sewn to the back half of the vas.
The remaining inner layer of 10-0 micro-sutures has been thrown, and the sutures are about to be tied.
The completed vasovasostomy, with a second layer of 9-0 micro-sutures tied.
Identification and dissection of the vas on the other side.
The ends of the vas being brought together.
The inner layer of sutures has been thrown.
Patency is confirmed.
The completed vasovasostomy on the other side. Note the tiny opening in the scrotum, which is associated with less discomfort than if a larger incision were made.