UPDATE Journal
6th April 2000, page 505, Procedure in Practice “No-Scalpel Vasectomy”
 

 No-Scalpel and no stitches  vasectomy procedure:

An effective, painless and virtually bloodless procedure. 

In England, about 35,000 operations are performed annually. Vasectomy has become one of the most popular forms of contraception, is safe, quick, highly effective and relatively cheap. It is much safer & more effective than female sterilization.

 Improved Technique For A Popular Procedure
Traditionally, the conventional technique required an incision in the scrotum, stitches, and causes some degree of post-operative discomfort. However, the no-scalpel vasectomy does not involve an incision.

Two unique instruments are used to perform the procedure: a specially designed vas fixation clamp (ringed forceps) to encircle and secure the vas without penetrating the skin (Fig1), and a curved surgical forceps with sharpened points to puncture the skin and vas sheath and to stretch a small opening in the scrotum (Fig2). The vas is delivered with the same forceps (Fig3) and the upper end occluded with a high-frequency hyfrecator diathermy (Fig4). (More slides)

Figure 1 Figure 2 Figure 3 Figure 4
vasectomy surgery vasectomy surgery 2 vasectomy photo 3 vasectomy photo 4

Benefits of the No-Scalpel Technique
Patients seem to prefer the option of a procedure suture free, involve just a single small puncture and causes less post-operative swelling.

Because the opening is so tiny, there is much less risk of infection, recovery time is usually shorter, and the healed puncture wound is almost invisible.

Average time off work after a no-scalpel vasectomy is 1.8 days, rather than 3.5 days with the standard vasectomy.

The rate of complications such as hematoma, and infection, is just 0.4% compared with the 3.4% for a conventional vasectomy.

The duration of the procedure is 10-15 minutes on average – up to 50% faster than conventional techniques.

Patients and methods 
A total of 1150  men have had a no-scalpel vasectomy in our clinic during the past 52 months.We have assessed postoperative pain, recovery time, and complication using questionnaire. The results are shown in Box 1, compared with a group of historical controls who underwent vasectomy by the standard technique.

Complication No Scalpel Vasectomy Traditional Vasectomy
Infection 0.2%(one patient, resolved with 7days course of antibiotic 3.48%
Pain, Swelling & Bruises 0.5% 3.48%
Haematoma 0.2 % (One patient, resolved spontaneously in 10 days) 2%
Sperm Granuloma 0.8% 2.8%
Epididymitis 0.5% 1%
Failure after one year 0.2% < 0.5%
Recovery Time 1.5 days 3.5 days

The rate of complications was much lower in the no-scalpel group, recovery was faster and the rate of pain, bruising and swelling was tenfold less than in men who had undergone a standard vasectomy.

Practical Points

  • Vasectomy is a popular, safe, quick, highly effective and relatively cheap form of contraception.
  • The no-scalpel and no-sutures technique reduces morbidity, complication rates and recovery time.
  • Because the opening is tiny, there is much less risk of infection.
  • The rate of pain, bruising and swelling is tenfold less than with the conventional technique.
  • The average time off work for patients is 1.8 days, compared with 3.5 days with a conventional vasectomy.