At ICVR, the vasectomy reversal procedure is normally performed under "conscious sedation." Small amounts of intravenous sedatives and relaxing medications are administered throughout the reversal to keep you happy, relaxed and comfortable. With conscious sedation, you save the expense of a much deeper general anesthesia and avoid the post-procedure nausea and other risks inherent in using general anesthesia.
Throughout the surgery as well as after the reversal we monitor heart rate, blood pressure, breathing, oxygen level and degree of sedation to ensure your safety. Drs. Marks and Burrows' focus is to do whatever needs to be done with the least disturbance to the surrounding tissues, preserving adjacent nerves and blood vessels so as to minimize any unnecessary swelling and maximize a healthy recovery.
During the vasectomy reversal procedure, the scarred ends of the vas deferens are microsurgically removed and the fluid from the testicular side of the vas is analyzed. We look at the color, the consistency, the volume of the fluid, presence or absence of sperm and whether the sperm are normal, intact and moving. After healthy fluid is found, the ends of the vas deferens are reconnected. This process is followed on both sides, therefore it is actually two surgical procedures.
Drs. Marks and Burrows achieve the highest surgical success rates for their patients using the formal multi-layer technique using 10-0 or 11-0 microsutures, even though this technique is more challenging and time consuming. Sometimes, when the scarring is too severe, it is necessary to reconnect the vas at the epididymis. There is no way to predict before surgery when this procedure will be required. Therefore, it is absolutely essential that you choose a surgeon that is as experienced performing this procedure as a normal vas-to-vas connection.
Drs. Marks and Burrows only perform microsurgical vasectomy reversals, using a new top-of-the-line Leica/Wild high-power surgical microscope with Swiss optics. This provides the best visualization possible, improving the accuracy and precision of each suture placed considerably. They also have the entire surgery viewable on a close-circuit monitor, which allows them to record and photograph the surgery. All patients receive intraoperative photographs when they are discharged, as well as photographs of the vas deferens fluid.
The best predictor of a successful vasectomy reversal procedure is the microsurgical skill and expertise of the surgeon. The level of skill required can only be achieved and maintained when the surgeon is performing vasectomy reversals at least 3-4 times a week over a period of years.
