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Vasectomy reversal procedure using robot-assisted surgery


Urologists at University of Florida have recently used robot-assisted surgery to perform a vasectomy reversal procedure. As a result they have succeeded to cut about 20 minutes off average surgery time for conventional vasectomy reversal using a microscope.

The director of men fertility and microsurgery at University of Florida said that for a couple that's trying to get pregnant, this is a big deal. Sperm count after surgery is comparable over a year for the two procedures, but the robotic procedure appears to result in a quicker return of sperm count.

But robotic vasectomy reversal procedure is not without controversy among specialists who say that is a waste of resources to use an expensive robot to do something that is already done well simply with a microscope.

Another controversy is the robot-assisted vasectomy reversal costs more than $3,000 more than the microscope method. As most patients pay out of pocket for vasectomy reversal, the biggest question is if the robot-assisted surgery improves outcomes - either pregnancy rates or the time spent in surgery.

Since many hospital fees are based on time, it is very important that the robot-assisted surgery has shown a meaningful decrease in the amount of time compared to the open procedure. This time reduction happens because the robot allows for more efficient use of instruments with the use of multiple arms and tools simultaneously.

In regards with whether pregnancy rates have improved, it is too soon to tell conclusion of the one-year study in which 20 men had the robotic procedure and seven had the microscopic one. According to evidences after two months surgery, average sperm count in the robotic surgery group was 54 million, compared with 11 million in the microscopic surgery group. However, early results show that the difference in sperm count between the two procedures decreases over time.

Less discomfort for those surgeons who would otherwise stand or sit with their backs bent for extended periods over a microscope, it is considered as an additional advantage.

But robot-assisted procedure has its limitations too. Urologists believe that surgical results of the robotic procedure will prove equivalent to the microscopic method, but might not be as useful for a very complicated reversals involving clearing a secondary blockage that develops close to the testicles. To improve the vasectomy reversal success rate urologists developed techniques to stabilize such small tubules while using the robot.

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