No Scalpel Vasectomy
No Scalpel Vasectomy – The Technique & Benefits.
What Is It?
A No Scalpel Vasectomy is done like keyhole surgery. Traditional vasectomies require two incisions and stitches. The NSV method, though, only requires one small incision at the front of the scrotum. Because the incision is shallow, no stitches are needed and healing time is minimal.
Lack of complicated surgery means patients can return to work, and life, sooner.
From Start To Finish
You go from the consultation room to the procedure room.
You’re asked to remove your shoes and lie on the couch. You put on a hot water bottle to relax the scrotal muscles.
The electric couch lifts to the correct height, and the doctor asks you to lower your clothes to your shins.
The doctor does the “wash down” with warmed antiseptic solution. A small amount of local anaesthetic is applied.
The doctor starts with the left side with a specialised instrument that is applied to the left tube.
The left tube is electro-cauterised and separated.
The right tube is brought up through the same small hole.
The procedure is completed on the right side.
A small dressing is applied and you have some recovery time.
WHAT DO THE LEADING VASECTOMY GUIDELINES HAVE TO SAY?
The UK’s internationally-respected Faculty of Sexual & Reproductive health care guideline (FSRH 2014) states that “a minimally invasive approach should be used to expose and isolate the vas deferens during vasectomy as this approach results in fewer early complications in comparison to other methods.”
NSV is recommended above traditional vasectomy in The American Urological Association Vasectomy Guideline which specifically states in their amended 2015 guideline that “Minimally Invasive Vasectomy should be used for Vas Isolation.” The European Association of Urology Guidelines on Vasectomy guideline (2012) states the same.
The Vasectomist uses one of the three methods of vas occlusion (No Scalpel, inline) equally recommended in this guidelines (AUA 2015 – P.21, guideline statement 7.2) & the other guidelines above (FSRH/EAU).
SHOULD The Vasectomist BE PERFORMED UNDER SEDATION?
A vasectomy is usually performed under local anaesthetic without sedation. Local anaesthetic vasectomy is safe, quick and painless. The 2015 national US Vasectomy guideline makes a positive recommendation that local anaesthetic is routine used: “Vasectomy should be performed with local anesthesia with or without oral sedation” (statement 5).
In The UK, almost all vasectomies are performed under local anaesthetic, and audit results from the primary care surgical association show very high levels of satisfaction.
There are very few patients who are not nervous about having a vasectomy. Thankfully, the vast majority say the procedure was nothing like they thought it would be.
Sedation is probably better suited to the minority who are particularly anxious. This is however, more complicated. Sedation vasectomy is performed in a hospital setting, usually by a urologist. The sedation is administered by an anaesthetist.
The Vasectomist Service & Local Anaesthetic
An ultra-fine hypodermic needle is used to insert a small bleb of local anaesthetic just under the skin whilst the skin is stretched to reduce any discomfort. More local anaesthetic is then infiltrated around the actual tubes.
What Sort of needle do you use?
The Vasectomist specially sources the ultra-fine 32G needle is specially sourced by My Vasectomy.
See this needle comparison chart. The 32G causes minimal to no discomfort.
Note: the higher the number, the smaller the needle.
The diameter of a 32G needle is 0.2 mm. Much finer than any vaccination or blood test needle.
