Vasectomy Reversal Surgery, Procedure

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Vasectomy reversal (vasovasostomy) is a surgical procedure that typically takes between 2-3 hours to perform, depending on the complexity of the specific case. Dr. Wise describes it as sewing together two pieces of spaghetti with a tunnel in the central. A small incision is created on either side of the higher pocket. After the duct is found, the vasectomy site is identified. Scar tissue is removed and the vas is divided above and below the vasectomy site. The abdominal side of the vas is examined to verify patency, and the testicular side of the vas is inspected for the presence of fluid. If there are sperm current, or if there is freely flowing fluid, the ends of the vas are reconnected.

The key to the pass of a vasectomy reversal is the skill of the surgeon, optimal magnification, and the use of microscopic sutures. Dr. Wise performs the reconnection of the vas with an inner layer of 10-0 Nylon suture and an outer layer of 9-0 Nylon suture, with further buttressing sutures utilized as needed. All sutures are thrown and tied below the binocular microscope.

Vasoepididymostomy (V-E) is indicated if there is no fluid expressed from the vas, or if there is thick and pasty fluid. This can be an indication of epididymal obstruction or presumably a blow out of the canal. This is not a typical finding if the ablation was performed but ten years before reversal. The epididymal tubules are wherever the sperm cell mature before getting into the duct. As such, the connection to the vas at the time of vasoepididymostomy is performed at the most distal part of the epididymis possible. Dr. Wise will perform the V-E procedure if needed at no extra charge at the time of surgery.
Location: 25 Michigan St NE #3300, Grand Rapids, MI 49503, USA

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