Video Technique for Human Robot-Assisted Microsurgical Vasovasostomy

Parekattıl, Sıjo J.; Atalah, Hany; Cohen, Marc

doi:10.1089/end.2009.0235

Cited by 41 publications

(17 citation statements)

References 10 publications

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“…To date, there have only been two published reports to detail the outcomes of robot-assisted vasovasostomies in humans. Neither report included pregnancy rates, and patency after robot-assisted reconstruction was either inferior or on par with traditional microsurgery (58,59). Given these results and the expense of robot-assisted surgery, we advocate a traditional microsurgical approach to vasal reconstruction.…”

Section: Surgical Techniquementioning

confidence: 99%

Obstructive azoospermia: reconstructive techniques and results

Baker¹,

Sabanegh²

2013

Clinics

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Obstructive azoospermia is a common cause of male infertility and can result from infection, congenital anomalies, or iatrogenic injury. Microsurgical vasal reconstruction is a suitable treatment for many cases of obstructive azoospermia, although some couples will require sperm retrieval paired with in-vitro fertilization. The various causes of obstructive azoospermia and recommended treatments will be examined. Microsurgical vasovasostomy and vasoepididymostomy will be discussed in detail.The postoperative patency and pregnancy rates for surgical reconstruction of obstructive azoospermia and the impact of etiology, obstructive interval, sperm granuloma, age, and previous reconstruction on patency and pregnancy will be reviewed.

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Section: Surgical Techniquementioning

confidence: 99%

Obstructive azoospermia: reconstructive techniques and results

Baker¹,

Sabanegh²

2013

Clinics

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“…In our opinion, the three-layer technique is insignificantly more time-consuming than both the previous oneor two-layer techniques (Fischer & Grantmyre, 2000;Marmar, 2000;Paick et al, 2000;Ho et al, 2005;Jee & Hong, 2010) and the robotic techniques currently published (Fleming, 2004;Kuang et al, 2004;Parekattil et al, 2010). One reason for our preference of the three-layer technique over the one-or two-layer technique is the possibility of exact adaptation of the interior layer which typically shows luminal disparity.…”

Section: Operation Techniquementioning

confidence: 90%

Vasectomy reversal using a microsurgical three‐layer technique: one surgeon’s experience over 18 years with 1300 patients

Schwarzer¹

2012

Int J of Andrology

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The technique and the results of microsurgical vasectomy reversal in a single-centre study over 18 years are presented. Both vasovasostomy (VV) and epididymovasostomy (EV) were carried out in a three-layer technique. With strict adherence to the strategy, end-to-end VV was only performed if spermatozoa had been demonstrated at the epididymal stump of the vas. In all other cases, EV was carried out in a preocclusive region of the epididymal tubule. The outpatient procedure of refertilization was associated with a very low complication rate, which underlines its minimal-invasive character. The follow-up rate was 71%, the overall patency rate was 89% and the pregnancy rate was 59%. Secondary azoospermia was only observed in 1% of the patients. In relation to the intervals of obstruction, the patency and pregnancy rates were higher after short-term obstruction than after long-term obstruction. Correspondingly, higher success rates were found after VV than after EV. This is understandable because the probability for indication of EV increases with longer periods of obstruction. There is a significant discrepancy between patency and pregnancy rates that is likely to be caused by a relevant number of patients with post-operative asthenozoospermia. The duration of obstruction is an important factor concerning epididymal damage, but it only disproportionately affects the results of refertilization if the technology of EV is implemented consistently in case of an epididymal granuloma. Good clinical results are achieved with this strategy, as evidenced by pregnancy rates and semen analyses.

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“…In 2005, multilayered RAVR was performed in a rabbit model (19). In 2010, the first comparative human study was published between RAVR and traditional microsurgical vasectomy reversal and showed shorter operative times and improvement in early semen analysis measurements in the RAVR group compared to microsurgical vasectomy reversal group, by a single surgeon (20). The RAVR technique was validated in 2014 showing equivalent operative times, patency rates, sperm concentration, and total motile sperm count in comparison to traditional microsurgical cases performed by a different single surgeon.…”

Section: Robot Assisted Mscdmentioning

confidence: 99%

Robot-assisted microsurgery for chronic orchialgia

Kavoussi¹,

Calixte

Brahmbhatt

et al. 2017

Transl. Androl. Urol.

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Chronic orchialgia is one of the most common complaints seen in the urologists office and has traditionally been considered a very difficult diagnostic and therapeutic challenge for the clinician. First line management of chronic orchialgia is conservative treatment; however, in men who fail conservative therapy, surgical intervention may be indicated. Microsurgery has been the mainstay for surgical treatment of chronic orchialgia, but the implementation of robotics to microsurgery lends itself particularly to surgical treatment of chronic orchialgia. PubMed was used to perform a current literature search on chronic orchialgia with robotic microsurgery, robotic spermatic cord denervation, robotic varicocelectomy, and robotic vasectomy reversal. Although conservative therapy is considered the first line treatment for chronic orchialgia, reported outcomes are moderate to poor, with the need to proceed to surgical intervention in select cases. Current surgical therapies in which robot assistance have been applied to microsurgery include microsurgical denervation of the spermatic cord, varicocelectomy, and vasectomy reversal. As further studies have assisted in the understanding of surgical treatment of chronic orchialgia, the application of robot assistance to this level of microsurgery has been shown to be feasible and safe with comparable outcomes to traditional microsurgery and may provide potential advantages.

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Video Technique for Human Robot-Assisted Microsurgical Vasovasostomy

Cited by 41 publications

References 10 publications

Obstructive azoospermia: reconstructive techniques and results

Obstructive azoospermia: reconstructive techniques and results

Vasectomy reversal using a microsurgical three‐layer technique: one surgeon’s experience over 18 years with 1300 patients

Robot-assisted microsurgery for chronic orchialgia

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