There are quite a few vasectomy techniques to choose from – traditional vasectomy, no-scalpel vasectomy, laser vasectomy and clip vasectomy. Below is a rundown of how each method is performed.
The traditional vasectomy is a small surgical procedure performed in a surgical center or doctor’s office that typically takes about 30 minutes to complete. Using a scalpel, your doctor makes 1-2 small incisions in the skin of the scrotum to access each testicle’s vas deferens tubes. The tubes are then lifted, cut, and tied or cauterized. The cut tubes are placed back into the scrotal sac before each incision is stitched up, and the sutures are removed in a week. Patients who undergo a traditional vasectomy typically experience more pain and swelling and longer recovery time due to more trauma, bleeding and sutures. Fewer surgeons learn the traditional vasectomy technique nowadays.
Most of the steps involved for a laser vasectomy are the same as those of a traditional vasectomy. Incisions must first be made in the scrotal skin so that your doctor can access the vas deferens tubes. After the tubes are lifted, a laser is usually used to cut the tubes or stop any bleeding, or a smaller laser wire is used to coagulate the lining of the vas tubes. However, because a laser is not actually needed, there is no significant advantage to using one for a vasectomy. The name “laser vasectomy” is used more for marketing purposes than for actual procedure benefits. Most vasectomies are usually performed with a battery-operated disposable eye cautery.
The vas clip idea is not new. The use of clips, or permanent staple-like devices, was expected to shorten a vasectomy’s overall procedure time without actually cutting the tubes. These clips cost the patients extra money, typically a few hundred dollars for titanium clips. Studies have also reported that the Vasclip is less effective than the no-scalpel vasectomy for reducing sperm count. To date, there is insufficient evidence showing that the Vasclip is better than a standard vasectomy or offers any known advantages compared to no-scalpel vasectomy techniques. Some insurance companies consider this procedure to be investigational and will not pay for it.
Developed in China in the 1970s, the no-scalpel technique is a minimally invasive procedure that does not require a large skin cut or sutures. In the past few decades, it has become increasingly popular around the world, as it is considered a more gentle vasectomy technique that minimizes bruising and discomfort. Other advantages include less noticeable scars and quicker recovery time.
While a scalpel is not used for this method, an opening must still be made in order to access the vas deferens tubes. Under local anesthesia, your doctor uses a specially designed sharp hemostat to penetrate the skin. After he locates and holds the tubes using a small ring clamp, he uses same hemostat to separate the tissue layers and pull the tubes out; the tubes are cut and cauterized a battery-operated disposable eye cautery, and a tiny metal clip is applied to each vas fascia to separate the ends and improve the effectiveness. After placing the tubes back into the scrotal sac, your doctor usually allows the openings to close on their own since the incisions are significantly smaller than those of a traditional vasectomy procedure.