Vasovasostomy done by sutureless vascular closure staples.

Surgical reconstruction of the male reproductive tract in the case of azoospermia is the most effective way of treating this condition. Vasovasostomy patency rates is 90% or higher with pregnancy rates of 70% in patients with demand for vasectomy reversal surgery. However microsurgery requires special training and can be difficult. Although microsurgery has improved the results of vasovasostomy this procedure remains time-consuming and challenging to many urologists. Recent efforts have focused developing procedures that are less time-consuming and easier to perform and have the same or better results. The microvascular clip has been designed to replace sutures in neurologic vascular anastomosis. Using this clip anastomoses have successfully been performed in blood vessels biliary system and urinary tract without special skills. The purpose of this study was to compare the efficacy of a new vasovasostomy technique using the microvascular clip to the conventional microsutured vasovasostomy. To evaluate the efficacy of sutureless vasovasostomy using vascular closure staples 20 male Sprague-Dawley rats were used for the study. In each rat a sutureless vasovasostomy using vascular closure staples was performed on a randomly selected side and a conventional end-to-end microsutured anastomosis was performed on the opposite side. Operation time was significantly shorter for sutureless vasovasostomy using vascular staples. 4 weeks after the surgery however patency rate and granuloma formation was not different for conventional end-to-end vasovasostomy versus sutureless vasovasostomy. These findings suggest that sutureless vasovasostomy is simple to perform and requires fewer special technical skills. This procedure may provide an alternative to the conventional vasovasostomy. (full text)