Robotically Assisted Vasectomy Reversal

Robotic surgery can improve vasectomy reversal by adding greater accuracy to the procedure, according to a pioneer in the field of robotically assisted urologic microsurgery.

Richard W. Graham, M.D., of the Virginia Urology Center (Richmond, USA; www.uro.com), recently performed a robotically assisted microsurgical vasovasostomy for vasectomy reversal, which he says was the first such procedure to be performed using robotic surgery. Dr. Graham has pioneered such robotic procedures in the field of urology. The system he uses is the da Vinci System from Intuitive Surgical Systems (Sunnyvale, CA, USA).

The success of vasectomy reversal has been attributed to the advent and skilled use of microsurgery, allowing the ends of the vas deferens to be rejoined more accurately. The da Vinci System is particularly beneficial for this application because it provides adjustable motion scaling in which the movement of surgical instruments is scaled down to one-fifth the movement of the surgeon's hand, allowing more precise manipulation and stitching and elimination of tremor. The system also provides a 3-D color view of the operating field, including depth perception for manipulating delicate tissue layers.

In addition, the da Vinci System also allows surgeons to perform laparoscopic surgery intuitively. The surgeon moves a control clockwise and the robot's instruments twist clockwise. In standard 2-D laparoscopic surgery, the movement of instruments is counterintuitive, similar to doing surgery while looking in a mirror.

"Leakage of sperm from the vas surgical site may cause inflammation and subsequent blockage, perhaps the biggest reason that vasectomy reversals fail,” explained Dr. Graham. "Clearly, the placement of sutures with the aid of motion scaling and optimal magnification ensures the most precise technique and successful outcome.”




Related Links:
Virginia Urology
Intuitive Surgical Systems