The following slides demonstrate an Open Ended No Scalpel Vasectomy Procedure.
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1st Step: the shaved site is washed with Betadine surgical scrub.
2nd Step: drape is placed to create a sterile field.
3rd Step: using a 10ml syringe with a 1 1/4", 27ga needle, about 2-3ml of 1% buffered Lidocaine was injected into the surface of the skin.
4th Step: the needle was advanced forward through the numb skin into the sheath of the left and then the right Vas Deferens, injecting about 2-3ml of Lidocaine, into each Vas Deferens.
5th Step: the Vas is found within the scrotum using a three finger method, and brought under the numbed skin area, then secured with a special Vasectomy ring clamp.
Close up of the 5th step. The ring clamp is placed over the numbed skin of the scrotum (you won't feel this), clamped to the Vas Deferens, and then pulled over, bringing the Vas into perfect position. As you can see the skin of the scrotum has been stretched really tight around the Vas, and will make the next step much easier.
6th Step: using a hand held electro surgical pencil a 3/16" incision was made at the most prominent point of the clamped Vas.
7th Step: dissecting forceps were used to spread the scrotal opening.
8th Step: a second vas clamp is used to grasp the perivasal sheath (the outer covering of the Vas Deferens).
9th Step: again using the electro surgical pencil, an incision 3/16" long was made into the perivasal sheath.
10th Step: using dissecting forceps, the perivasal sheath was pushed and worked downward, exposing the Vas Deferens.
11th Step: the Vas is now free of the sheath.
12th Step: at this point I was experiencing some mild discomfort and another 1ml of Lidocaine was administered directly into the Vas Deferens.
13th Step: Vas pulled up and clamped each side, so as not to slip back inside the scrotum, during the next steps.
14th Step: cutting the looped Vas Deferens Free. (no turning back now)
15th Step: only the Prostatic end of each Vas is cauterized, using a electro surgical pencil set to cauterize.
This is another view of cauterizing the lumen (inner lining of the tube)
16th Step: Fascia of perivasal sheath is pulled over Prostatic Vas end and sutured with no.4-0 Dexon.
Another view of the 16th Step: finishing up suture. The cut Testicular end of the Vas was not cauterized or tied off. "Recent literature suggests that fewer complications result with this open-ended testicular technique."
17th Step: the ends of the Vas were released into the scrotum. The opening was cauterized and then checked for bleeding. As you can see, the single incision located at the base of the penis, closes to about 1/16", and no sutures were required. Antibiotic ointment was applied, then a band aid.
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The information presented is not designed or intended as medical advice.
Author Kevin B. Clever DC
Copyright © 1999 by Kevin B. Clever DC. All rights reserved.
Revised: 16 Jun 2009 06:13:59 -0700.