V8-04 INTRA-CORPOREAL ROBOTIC ASSISTED VASO-VASOSTOMY FOR THE MANAGEMENT OF BILATERAL VASSAL OBSTRUCTION FOLLOWING INGUINAL HERNIORRHAPHY WITH MESH

Abstract

You have accessJournal of UrologyMale Voiding/Infection/Infertility/Testis1 Apr 2014V8-04 INTRA-CORPOREAL ROBOTIC ASSISTED VASO-VASOSTOMY FOR THE MANAGEMENT OF BILATERAL VASSAL OBSTRUCTION FOLLOWING INGUINAL HERNIORRHAPHY WITH MESH Julie Wang, Landon Trost, Sijo Parekattil, Ronny Tan, and Wayne Hellstrom Julie WangJulie Wang More articles by this author , Landon TrostLandon Trost More articles by this author , Sijo ParekattilSijo Parekattil More articles by this author , Ronny TanRonny Tan More articles by this author , and Wayne HellstromWayne Hellstrom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2151AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Various surgical approaches have been described for the management of iatrogenic inguinal vasal obstruction, including open microscopic, laparoscopic, and robotic-assisted. Both the open and laparoscopic approaches are often limited in cases of extensive inguinal obstruction or inadequate intra-abdominal vasal length. The robotic approach offers novel opportunities to the operating surgeon, including performing microsurgical anastomoses in traditionally challenging locations. The current communication describes the first intra-corporeal robotic-assisted, microsurgical vasovasostomy (VV) for the treatment of iatrogenic vasal obstruction not amenable to standard microscopic repair. METHODS Bilateral intra-corporeal, robotic-assisted microsurgical VV’s were performed. The proximal vasa were transected, with obstruction of the distal segments confirmed. Following docking of the robot, the intra-corporeal regions of the vas deferens were transected at the internal ring. The proximal vas segments were then passed intra-corporeally and approximated with 5-0 prolene sutures. A standard two-layer anastomosis was then performed intra-corporeally using 10-0/9-0 sutures. RESULTS Total operative time was 278 minutes. No intra- or post-operative complications were noted. Semen analysis obtained eight weeks following the procedure demonstrated a total volume of 5.4cc, 8.4x10∧6 sperm/ml, 45.4x10∧6 total sperm, and 16% motility, consistent with a successful result. CONCLUSIONS This represents the first reported case of intra-corporeal outpatient VV. These results demonstrate the feasibility of the procedure and highlight unique aspects of the robotic approach, which may offer advantages over the traditional microscope in select cases. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e785 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Julie Wang More articles by this author Landon Trost More articles by this author Sijo Parekattil More articles by this author Ronny Tan More articles by this author Wayne Hellstrom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...