Hellstrom, W., Parekattil, S., Tan, R., Trost, L., Wang, J.

Robot-assisted microsurgery, vasovasostomy, male infertility

This video demonstrates the case of a patient with azoospermia secondary to bilateral mesh utilized in inguinal hernia repair. The patient was operated with the Da Vinci Robot with a combined intra and extra corporeal approach with a small extra corporeal incision. Length of the vas deferens was gained by this extracorporeal incision to achieve sufficient vas deferens intra corporeal for a patent anastomosis. For the anastomosis 3 intra and 3 extra luminal sutures 9/0 were used. Care is taken to make the anastomosis tension free. This patient was operated in day surgery setting, postoperative results are discussed and demonstrate a positive semen analysis after 8 weeks. 

1. Trost L, Parakattil S, Wang J, Hellstrom WJ. Intracorporeal robot-assisted microsurgical vasovasostomy for the treatment of bilateral vassal obstruction occurring following bilateral inguinal hernia repairs with mesh placement. J Urol. 2014 191(4):1120-5.
2. Gudeloglu A, Brahmbhatt JV, Parekattil SJ. Urol Clin North Am. Robot vasovasostomy. 2014; 41(4):559-66.