Human robotic assisted bilateral vasoepididymostomy and vasovasostomy procedures: initial safety and efficacy trial

Abstract

Our goal was to develop a robotic approach for vasoepididymostomy (RAVE) and vasovasostomy (RAVV) using a 4 arm High Definition Platform (Intuitive Surgical, CA) and present our human in-vivo results. All 3 RAVV procedures were successful and one patient had 102 million motile sperm/ml of ejaculate at 1 month post-op. The RAVE procedure patient only had a few non-motile sperm at 6 month follow up in his ejaculate. The use of robotics seems to offer advantages in terms of ergonomics and suture control. Further evaluation is needed to assess the clinical potential of robotics in vasectomy reversal.

Robotic-assisted microsurgery in andrology: a systematic review

“…Parekattil et al . 26 reported their first cases in 2009, with excellent results for the RAVV group, even in patients with many years (7, 18, and 19 years) postvasectomy. The same group compared, in 2010, 20 RAVV and 7 MVV cases performed by a single microsurgeon.…”

Robotic approaches for male infertility and chronic orchialgia microsurgery

“…The first human trials of RAVV/RAVE were done using the initial daVinci robotic system [24] and then the new daVinci Si system [25,26]. On the basis of these trials, roboticassisted reversal appeared to have an advantage over microsurgical reversal in terms of ease of performing the procedure and improved patency rates [21 ,22].…”

Robotic instrumentation: Evolution and microsurgical applications

“…These efforts have been recently confirmed in human RAVV cases performed using the new DaVinci S system. [ 27 ] We performed a prospective control study comparing initial results for RAVV in 20 human cases compared to seven standard microscopic vasovasostomies (MVV) cases by a single fellowship trained microsurgeon from July 2007 to June 2009. [ 28 ] A three-layer 10-0 and 9-0 suture anastomosis was performed with up to 22 months follow-up (mean three months).…”