Operating Microscope for Vasovasostomy

The use of the operating microscope and microsurgical technic is reported with success judged by reappearance of sperm in ejaculate and fathering of children in 3 men 1 failure and 1 lost to follow-up. Equipment includes the operating microscope spring release needle holder counter-press fine tipped forceps and scissors and 6-0 gut or 7-0 silk. Visualization must be kept clear and vas kept in the same plane of the microscope. Patency is determined with dye or cannulation at the distal end and by expression of epididymal fluid from the proximal stump. A splint was threaded through vas lumen at least 2 cm beyond anastomoses protruded through vas wall tied outside the skin and left 4-10 days. It is suggested that vasectomy still be regarded as irreversible.