Non scalpel vasectomy: the operation in 5 steps (and how to reverse it)

In this article we will talk about a specific surgical operation called non scapel vasectomy (NSV).

Before diving deep into this surgical procedure, let’s see the general definition of a vasectomy.

What is a vasectomy

A vasectomy is a surgical operation often chosen by men who seek permanent contraception. The operation leads to the patient’s sterilization, thus making them permanently unable to release sperm during ejaculation.

During a vasectomy, the vas deferens (the tubes that carry sperm from the testicles to the urethra) are either cut, sealed or blocked. The procedure typically takes around 20 to 30 minutes to complete.

Vasectomy is generally a safe procedure with few complications. However, just like with other surgical procedures, there are risks related to it, including bleeding, infection, and chronic pain. Therefore, it’s crucial for individuals considering a vasectomy to discuss the procedure thoroughly with a doctor and carefully weigh the decision before proceeding with it.

The steps of a vasectomy

A vasectomy operation follows specific steps:

Preparation. During this phase, the patient is given instructions in order to be prepared for the procedure. This phase may include shaving the scrotum and abstaining from medications that can increase bleeding.
Anesthesia. Local anesthesia is administered in order to numb the scrotum. In some cases, general anesthesia may be used as well.
Accessing the vas deferens. In this phase, the doctor makes one or two small incisions in the scrotum to access the vas deferens, which are cut and a small section may be removed. Then, the ends of the vas deferens are sealed or blocked using methods such as cauterization, ligation (tying off), or using clips (or other devices).
Closing incisions: The incisions in the scrotum are closed with stitches or surgical glue (if necessary).
After the operation. After a vasectomy, it’s important to use alternative methods of contraception until tests confirm that the semen is free of sperm. This phase usually lasts a few months and requires periodic semen analysis.

What is a non scalpel vasectomy

Non scalpel vasectomy is a specific type of vasectomy procedure which doesn’t involve the use of a scalpel. Instead, it uses a specifically designed ringed clamp and a dissecting hemostat to puncture the scrotum to access the vas deferens (as we’ll see later in more detail).

The NSV operation offers several benefits, like a lower risk of:

Bleeding;
Bruising;
Infection;
Pain.

The steps of a non scalpel vasectomy

So far we’ve taken a look at the steps required to perform a regular vasectomy. Now let’s see what are the steps for a non scalpel vasectomy:

Preparation: the patient is usually given a local anesthesia to numb the area.
Accessing the vas deferens: this phase represents the main difference from a regular vasectomy. For the non scalpel vasectomy, instead of making the incisions, the doctor locates the vas deferens under the skin and holds it in place with a special clamp.
Severing and sealing the vas deferens: the doctor then makes a small puncture or hole in the skin to access the vas deferens. Using specialized instruments, the doctor pulls a small section of the vas deferens through the puncture and then cut and seal it. This is often done using heat (cauterization) or by tying off.
Closing the puncture site: the puncture site is usually so small that it doesn’t require making stitches. It generally closes by itself.
Recovery: recovery from the operation is generally quicker compared to traditional vasectomy. Generally, the patients can resume their normal activities within a few days, although strenuous activity and sexual activity may need to be avoided for a week or two.

The missing element: the scalpel

We’ve seen how the absence of the scalpel is the main element that differentiates the non scalpel vasectomy from a regular one. But what exactly is the scalpel?

The scalpel is the surgical tool also commonly referred to as bistouri. It is a small bladed instrument that can be either single-use, re-usable or disposable.

Is it possible to reverse a regular or a non scalpel vasectomy?

Regular and non scalpel vasectomy are both considered effective forms of contraception, with a failure rate of less than 1%. However, it’s important for individuals to understand that it is meant to be permanent, although it’s possible to undergo reversal procedures, which are however not always successful.

What is a reverse vasectomy

A reverse vasectomy (also called vasovasostomy), is a surgical procedure performed to restore male fertility for the patient who have previously undergone a vasectomy. During a vasectomy reversal, the vas deferens – which are previously cut or blocked during the vasectomy – are reconnected to allow sperm to once again enter the ejaculate.

The steps of a reverse vasectomy

Here are all the steps of a reverse vasectomy:

Preparation: the patient must be prepared to undergo a reverse vasectomy. They might even need to abstain from medications that can increase bleeding.
Anesthesia: just like for the two type of vasectomies that we have described, the reverse vasectomy starts from administering anesthesia to the patient, to ensure that they are comfortable during the procedure.
Accessing the vasectomy deferens: the surgeon then makes a couple of small incisions in the scrotum to access the vas deferens (the surgeon might even need to make a single, larger incision).
Reconnecting the vas deferens: the ends of the vas deferens that were previously cut or blocked are carefully located and reattached. This step is performed with the help of microsurgical tools (like the surgical microscope).
Testing patency: once the vas deferens are reconnected, the surgeon checks for the free flow of sperm through the tubes to confirm that the procedure was successful.
Closing incisions: after the reverse vasectomy is performed successfully, the incisions in the scrotum are closed with stitches or surgical glue.

The success of the operation depends on various factors including the length of time since the original vasectomy and the method used to perform it.

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