New Bipolar Radiofrequency Sealing tool for Transdermal Vasectomy in the Rabbit Model: a Paradigm Shift in Vasectomy Technique?

Abstract

ABSTRACT Introduction Bipolar Radiofrequency (RF) sealing tools have been shown to be successful in the treatment of many areas in the human body. RF has been utilized in the sealing of larger blood vessels and in nerve pain ablation in humans, showing good results for years. Urology has used RF ablation percutaneously for treating renal tumors for years. Objective We evaluate the utilization of a new bipolar RF sealing tool for transdermal vasectomy in the rabbit model. Methods Two groups of 5 male New Zealand white rabbits were given IV sedation and local anesthetic and subsequent transdermal bilateral vasectomy using a high lateral scrotal approach. We isolated the vas with a novel insulated clamp, fitting the U-shaped electrode of the sealing tool (Figure 1) around the clamp. In Group 1 (n=5), the device was set at 60 watts for 20 seconds. In the second group (n=5), the size of the U-shaped tool jaw was reduced and the device was set at 40 and 60 watts using impedance sensing to automatically shut off energy at a predetermined level. Wound healing, complications, survival, postmortem biopsies, and histology were evaluated. A doe rabbit was used with semen collections & semen analyses preformed on all male rabbits. Results We sacrificed 4 of the 5 (80%) of Group 1 rabbits due to poor wound healing due to excessive thermal damage. All 5/5 (100%) of Group 2 rabbits had good tissue healing and survived the procedure. At about 5 seconds of sealing, the impedance sensing automatically shut off power to the device in all Group 2 procedures. All rabbits had a negative semen analysis and on histology had occluded vas deferens. In bench top testing, we found that a 5 second interval is optimal for vas ligation. (Figure 1) Bench top testing revealed that thin short jaws created lower nearby tissue temperature (50 degree Celsius) than wide long jaws (77 degree Celsius). Conclusions Transdermal bipolar radiofrequency sealing successfully occludes the vas deferens in rabbit vasectomy. The jaw size and sealing time using an impedance alarm system appear to be important for wound healing. This novel technique may decrease vasectomy time and morbidity. Further studies are needed before its application in humans. Disclosure Yes, this is sponsored by industry/sponsor: Signati Clarification: Industry initiated, executed and funded study Any of the authors act as a consultant, employee or shareholder of an industry for: Signati