It is essential to have an absolutely clear view through the microscope to ensure correct placement of each suture. This view has been captured through a Zeiss microscope with a Xenon light source. This can magnify up to 40 times and is used in conjunction with an assistant's eyepiece.
In this video the two ends of the vas tube are being joined at the previous vasectomy site using the Owen Three-Layer Closure technique. The vas tubes are approximately 2 mm in diameter/across. The tiny capillaries are clearly seen on either side of the vas anastomosis (join); these are essential for good healing. There must not be any pressure or tension on the vas cord during or after the completion of the anastomosis in order to preserve the delicate capillary blood supply.
Using a small non-cutting tapered needle minimizes unwanted scarring. When tying the sutures the tension must not be too tight to cut off the supply of blood in the capillaries and not too loose so that the sutures come undone.
Our dedicated assistant looks down the microscope eyepieces also during the procedure to ensure that accuracy is maintained. Operating time on average is between two to three hours, half of which is spent finding and preparing the two ends of the vas to allow re-joining. This is again repeated on the second side of the scrotum. In this video the final moments of suturing are shown.
This team approach includes our experienced scrub sisters, theatre and anesthetic nurses, and our anesthetic specialist who all assist in optimizing the safety of the procedure.
A full account of the suturing technique is demonstrated at each consultation. Surgery is recorded for patients and partners to view post operatively.
