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Combined robotic and subinguinal microsurgical vasovasostomy for vasal obstruction after inguinal hernia repair
Journal article   Open access   Peer reviewed

Combined robotic and subinguinal microsurgical vasovasostomy for vasal obstruction after inguinal hernia repair

Moshe Wald and Ryan Steinberg
BMJ case reports, Vol.15(6), p.e249137
06/01/2022
DOI: 10.1136/bcr-2022-249137
PMCID: PMC9240829
PMID: 35764335
url
https://www.ncbi.nlm.nih.gov/pmc/articles/9240829View
Open Access

Abstract

Obstruction of the vas deferens may occur after inguinal hernia repair with mesh and lead to infertility. In cases where natural conception is desired and after obtaining test results that suggest the presence of spermatogenesis, surgical reconstruction can be attempted but may be difficult. Several approaches have been reported, including the laparoscopic mobilisation of the pelvic vas deferens, as well as mobilisation and passage of the scrotal vas deferens intra-abdominally for robot-assisted vasovasostomy. We describe a novel approach that used the surgical robot and a no-touch technique to mobilise the pelvic vas deferens and deliver it to the subinguinal region for subinguinal microsurgical vasovasostomy. This approach appeared to be feasible and safe, allows for simultaneous bilateral repair if needed, and was associated with rapid postoperative convalescence.
General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology

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