Abstract
Of all patients who have vasectomies performed in the United States, upwards of 6% will pursue a vasectomy reversal. Currently, the gold-standard reversal procedure is a microscopic vasovasostomy utilizing either a one or two-layer vasal anastomosis. Unfortunately, most urologists do not perform these procedures as they require extensive training and experience in microsurgery. The objective of our study was to evaluate the feasibility and success rate of robot-assisted vasovasostomy performed at our institution. We completed a retrospective review of our experience with vasectomy reversal utilizing the da Vinci® Surgical System and a single layer vasal anastomosis. A successful reversal was defined as a return of sperm on semen analysis or light microscopy. Since 2009 we have completed 79 robotic vasectomy reversals, 60 of which utilized a single-layer vasal anastomosis. The average obstructive interval was 5.7 ± 2.2 years. Average operative time was 192 min. 42 patients returned for a post-operative semen evaluation at an average time of 4.3 months post-procedure revealing a success rate of 88% (37 out of 42). Post-operative semen parameters were significant for an average sperm density of 31.0 million/mL with an average motility of 29.1%. Robot-assisted vasovasostomy with a single layer anastomosis has overall success rates that are similar to that of reported microscopic vasovasostomy rates. Although more study is warranted with regard to cost, we feel as though our study demonstrates an alternative approach to vasectomy reversal that can be performed successfully by urologists trained in robotic surgery.
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Abbreviations
- VV:
-
Vasovasostomy
- MVV:
-
Microscopic vasovasostomy
- RAVV:
-
Robot-assisted vasovasostomy
- sRAVV:
-
Single-layer anastomosis robot-assisted vasovasostomy
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Drs. Marshall, Doudt, Berger, Auge, Christman, and Choe declare that they have no conflict of interest.
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The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government. The authors are military service members. This work was prepared as part of their official duties. Title 17, USC, § 105 provides that ‘Copyright protection under this title is not available for any work of the United States Government.’ Title 17, USC, § 101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties.
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Marshall, M.T., Doudt, A.D., Berger, J.H. et al. Robot-assisted vasovasostomy using a single layer anastomosis. J Robotic Surg 11, 299–303 (2017). https://doi.org/10.1007/s11701-016-0653-1
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DOI: https://doi.org/10.1007/s11701-016-0653-1