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11 January 2010
Vasectomy reversal improved with robotic help
by George Atkinson

Urologists from the University of Florida (UF) have used robot-assisted surgery to cut about 20 minutes off the average time for a vasectomy reversal while also delivering a quicker increase of sperm count. "For a couple that's trying to get pregnant, this is a big deal," said study leader Sijo Parekattil, director of male infertility and microsurgery at UF.

The findings, appearing in the Journal of Endourology, represent the first comparison of robot-assisted vasectomy reversal and the conventional microscope procedure that is widely used.

But robotic vasectomy reversal is not without controversy among specialists who say that using an expensive robot to do something that is already done well simply with a microscope is a waste of resources. Most patients pay out-of-pocket for vasectomy reversal and the robot-assisted procedure can cost more than $3,000 more than the microscope method.

But it appears that the robot-assisted procedure did improve outcomes - both in surgery time and recovery time to a full sperm count. Since many hospital fees are based on time, cutting operating time might offset some of the extra charges associated with the use of the robot.

The study notes that it is too soon to tell whether pregnancy rates have improved, but two months after surgery average sperm count after robotic surgery group was 54 million, compared with 11 million for men who underwent the microscopic procedure.

The study also found that the robotic procedure has its limitations, as it may not be as useful for more complicated reversals that involve clearing a secondary blockage that develops close to the testicles. In such cases, the surgeon has to hold the sperm tube during surgery. This is difficult to do robotically because a keen sense of pressure is needed in order to avoid crushing the microscopic tubes involved.

Related:
Vasectomy Linked To Dementia
Abnormal Sperm Result From Vasectomy Reversal
Vasectomy Not Related To Prostate Cancer Risk

Source: University of Florida




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