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Robots Assisting with Fatherhood

Approximately 500,000 men undergo vasectomy a year in the United States, and approximately six percent of men who undergo vasectomy will desire a vasectomy reversal sometime in their lifetime for a chance to be a Dad again.  Traditionally this is performed with a microsurgical technique utilizing an operative microscope over the patient’s body to magnify these structures for this fine, meticulous procedure.  The advent of the daVinci Robot surgery system has allowed for a new approach to vasectomy reversal.

The robotic system includes a surgeon’s console, a patient cart with four interactive robotic arms, a high performance 3-dimensional, high definition vision system, with microscopic endowrist instruments.  The surgeon sits at the console with controls to operate the robotic micro-instruments while visualizing the surgical field through the consoles monitor.  As the lumen (whole) in the vas deferens that has to be sewn back together is approximately the size of the period at the end of this sentence, and typically 12 sutures barely visible by the human eye are used to put the ends back together, this technique may offer some advantages.

Although the vasectomy reversal success rates, the incision, and the recovery are similar when comparing the microscopic versus the robotic techniques; the robotic platform is ergonomically designed for the surgeon and offers high definition-3D visualization.  This allows for a more comfortable surgeon with less fatigue during the procedure which may enhance performance.  There is some preliminary data showing that men who undergo robot assisted vasectomy reversal have return of higher numbers of sperm to the semen faster than those who undergo microsurgical vasectomy reversal (J of Endourol 2010).  This is early data which requires confirmation, but may be an advantage of robotic vasectomy reversal.

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