To learn more about Vasovasostomy, please select one of the following topics. Please note that content below includes some graphic images of the procedure. If you are ready to schedule a consultation for your vasectomy reversal, please request a consultation here.

• Vasovasostomy Technique
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    One surgical approach is the modified 1-layer connection (anastomosis) and the other is a formal, two-layer anastomosis. The technical differences in suture placement between these two approaches are shown in the figure below.

    

    FIGURE 2.SUTURE PLACEMENT FOR TWO LAYER AND
    MODIFIED 1-LAYER VASOVASOSTOMY

• Vasovasostomy Step-by-Step With Images
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    For this discussion, we will continue outlining the 2-layer method. The two freshened ends of the vas deferens are brought closer by placing small sutures (size 7-0) in the tissue around the vas deferens, thus drawing them together. A vas-approximating clamp can also be used. Once the two ends of the vas face each other, the formal microsurgical connection is begun. First the "back wall," outer (serosal) sutures (size 9-0) are placed, tying the knots on the outside to protect the lumen. Then, the inner (mucosal) layer of sutures is placed with ultrafine (10-0) suture. Vasectomy reversalist Dr. Turek uses 6 such sutures within the lumen, locating them approximately every "2 o'clock" (or every 60 degrees) around the circumference. The first three are placed and tied, in a manner that helps "triangulate" the vasal lumen to facilitate optimum placement of the remaining sutures (see figure below):

    

    FIGURE 3. VASOVASOSTOMY AFTER "BACKWALL" OUTER AND INNER SUTURES ARE PLACED AND TIED.

     

    

    FIGURE 4.VASOVASOSTOMY AFTER "BACKWALL" SUTURES ARE COMPLETE, WITH REMAINING “INNER” SUTURES PLACED BUT NOT TIED. SURGICAL PHOTO SHOWING SAME.<

     

    

    FIGURE 5.VASOVASOSTOMY AFTER ALL INNER SUTURES HAVE BEEN PLACED AND TIED. REMAINING OUTER SUTURES STILL NEED TO BE PLACED. SURGICAL PHOTO SHOWING SAME.

     

    

    FIGURE 6. VASOVASOSTOMY AFTER ALL INNER AND OUTER SUTURES HAVE BEEN PLACED AND TIED. SURGICAL PHOTO SHOWING SAME.

    Then, the remaining inner layer sutures are placed, followed by the remaining outer layer sutures to complete the 2-layer connection. This is in turn buttressed with more sutures (size 7-0) placed circumferentially around the sheath of the vas deferens to further strengthen the connection. The vas deferens is then placed back into the scrotum and local anesthesia given to ensure a comfortable and pain-free recovery. A similar procedure is performed on the opposite side through a corresponding incision. A scrotal support is placed on the patient and he is prepared for discharge. The local anesthesia keeps the surgical area numb for 2-4 hours after the procedure.

• After Your Vasovasostomy
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    Dr. Turek's patients take an average of 6 pain pills over the next several days after the procedure and can return to light activity (short walks, working at desk) within 3 days. Heavy physical activity, including sexual intercourse or sports, is limited for 3 or 4 weeks, depending on whether a vasovasostomy or epididymovasostomy is performed. More details in our vasectomy reversal patient information.

• Contact Dr. Turek about Vasectomy Reversal