UPDATE Journal
6th April 2000, page 505, Procedure in Practice "No-Scalpel Vasectomy"
No-Scalpel and no stitches vasectomy procedure:
An effective, painless and virtually
bloodless procedure.
In England about 35,000 operations are performed annually. Vasectomy has become one of the most popular forms of contraception, being safe, quick, highly effective and relatively cheap. It is much safer & more effective
than female sterilisation.
Improved Technique For A Popular
Procedure
Traditionally, the conventional technique required an incision in the scrotum, stitches, and causes some degree of post-operative discomfort. However, the no scalpel vasectomy does not involve an incision.
Two unique instruments are used to perform the procedure: a specially designed vas fixation
clamp (ringed forceps) to encircle and secure the vas without penetrating the
skin (Fig1), and a curved surgical forceps with sharpened points to puncture the skin and vas sheath and to stretch a small opening in the
scrotum (Fig2). The vas is delivered with the same forceps (Fig3) and the upper
end occluded with a high frequency hyfrecator
diathermy (Fig4). (More
slides)
| Figure
1 |
Figure
2 |
Figure
3 |
Figure
4 |
 |
 |
 |
 |
Benefits of the No-Scalpel
Technique
Patients seem to prefer the option of a procedure suture free, involve just a single small puncture and causes less post-operative swelling.
Because the opening is so tiny, there is much less risk of infection, recovery time is usually shorter, and the healed puncture wound is almost invisible.
Average time off work after a no scalpel vasectomy is 1.8 days, rather than 3.5 days with the standard vasectomy.
The rate of complications such as haematoma, and infection, is just 0.4% compared with the 3.4% for conventional vasectomy.
The duration of the procedure is 10-15 minutes on average – up to 50% faster than conventional techniques.
Patients and methods
A total of 1150 men have had no-scalpel vasectomy in our clinic during the past
52 months .We have assessed postoperative pain, recovery time, and complication using questionnaire. The results are shown
in Box 1, compared with a group of historical controls who underwent vasectomy by the standard technique.
| Complication |
No
Scalpel Vasectomy |
Traditional
Vasectomy |
| Infection |
0.2%(one patient, resolved
with 7days course of antibiotic |
3.48% |
| Pain,
Swelling & Bruises |
0.5% |
3.48% |
| Haematoma |
0.2 % (One patient, resolved spontaneously in 10 days) |
2% |
| Sperm
Granuloma |
0.8% |
2.8% |
| Epididymitis |
0.5% |
1% |
| Failure
after one year |
0.2% |
<
0.5% |
| Recovery
Time |
1.5
days |
3.5
days |
The rate of complications was much lower in the no scalpel group, recovery was faster and the rate of pain, bruising and swelling was tenfold less than in men who had undergone standard vasectomy.
Practical Points
- Vasectomy is a popular, safe, quick, highly
effective and relatively cheap form of contraception.
- No-scalpel and no-sutures technique reduces morbidity, complication rates and recovery time.
- Because the opening is tiny, there is much less risk of
infection.
- The rate of pain, bruising and swelling is tenfold less than with the conventional technique.
- The average time off work for patients is 1.8 days, compared with 3.5 days with a conventional vasectomy.
For Operative procedures and slides click here.
For contact and enquiries:
Dr.D.M.Muktar, MBChB., FRCS.
The GP Centre
322 Malden Road
Sutton, Surrey SM3 8EP
Tel: 020 8644 0224
Fax: 020 8288 1012
|