: Vasectomy is the most effective method of male contraception, with an estimated 500,000 vasectomies per year and rising. Naturally, as divorce rates have been steadily increasing, there has been a corresponding increase demand for vasectomy reversals. This poses some challenges- while vasectomies have become increasingly simple, quick, cheap, and noninvasive with techniques such as no-scalpel vasectomy, vasectomy reversal is still a relatively complicated microsurgical procedure that requires time, skill, concentration, and money. To give you an idea, the opening of the vas deferens (the tube which carries sperm to the semen) is 0.1mm wide, about as wide as a human hair. Knowing that, it makes sense why vasectomy reversals are harder than vasectomies; it’s a lot easier to cut it in half than stitch it back together. That’s not to say vasectomy reversal isn’t effective as it is now. Patency rates (moving sperm) have risen from 5-30% to 85-90% today with the advent of microsurgical techniques.
How can it get better?
Of course, vasectomy reversals aren’t always perfect. As time goes on, the chance of pregnancy goes down considerably. Also, the procedure is time-consuming and highly dependant on a physician’s skill. Robotic surgery is an exciting alternative that could theoretically mean a higher patency rate if there are no other complicating factors. Robotic surgery also theoretically has several potential advantages:
Smaller incisions- Little robot arms are a lot smaller than a doctor’s hands. Also means less scarring.
Visualization- Robots mounted with cameras can give detailed magnified images that the eye could not resolve
Pain- Robotic surgery is usually less painful and likely to develop complications
Time- Robotic surgery has the potential to be much faster than hands.
What does the research say though?
There have been vasectomy reversals that have been performed using robotic-assisted vasectomy reversal, but so far it does not offer a lot of advantages. Studies have given different results, but on average, robotic-assisted vasectomy reversals take just as long and are equal in patency rates. With no significant advantages over a regular vasectomy reversal, it’s not worth it for most hospitals and doctors to spend a lot of money on expensive robotic-assisted surgery equipment. However, that doesn’t mean robotic-assisted vasectomy reversals should be discounted. The technology is still in its infancy; who knows where it might be in 20 years down the road. As robots and AI get more advanced, operating time, precision, and effectiveness should increase, and the physical role of the surgeon will go down- not just for vasectomy, but all surgical procedures. It’ll be a while before that happens though. Your best bet right now is the tried-and-true vasectomy reversal, done by your local human doctor.
