Carbon Dioxide Laser-Assisted Microscopic Vasovasostomy

Abstract

Microsurgical vasovasostomy has become an increasingly important part of the urologist's armamentarium. We have combined the C02 laser at milliwatt powers to achieve welding with microsurgical techniques. We divided 30 adult male Sprague-Dawley rats into six groups: sham surgery, vasectomy, control microsurgical anastomoses, laser-assisted anastomoses with sutures left in, laser-assisted anastomoses with sutures removed, and sutureless anastomoses. Laser-assisted anastomoses were achieved using a Bioquantum C02 laser coupled to a Wild operating microscope. Power densities ranging from 5.1 to 8.5 watts/mm2 were utilized. All animals were sacrificed after 6 weeks; light and scanning microscopy was performed. Our results show the feasibility of laser-assisted anastomoses, although some animals in the sutureless group had sperm granulomas and anastomotic strictures. Laserassisted anastomosis using sutures for alignment, whether sutures were left in or removed following laser treatment, appeared equal to control microsurgical techniques. However, it is noted that the muscle wall thickness in the area of the vasovasostomy was significantly reduced in the laser-assisted groups; this result may imply vas wall weakness.