ABSTRACT
INTRODUCTION: Recent research on vasectomy shows that combining cautery and fascial interposition (FI) achieves the most effective occlusion of the vas and minimizes the risk of failure. We present a technique that combines cautery and FI and is suitable for low-resource settings. SURGICAL TECHNIQUE: The surgical technique consists of 1) exposing the vas with the no-scalpel approach; 2) cauterizing the epithelium of lumen of the vas using a portable battery-powered cautery device; 3) performing FI by grasping internal spermatic fascia and applying a free tie with suture material on the fascia to cover the prostatic stump of the vas and separate the two ends of the cut vas; and 4) excising a small 0.5 to 1 cm of the testicular stump. COMMENTS: To maximize vasectomy effectiveness, vasectomy providers should consider learning thermal cautery and FI to occlude vas deferens.
Subject(s)
Humans , Male , Cautery/methods , Vas Deferens/surgery , Vasectomy/methods , Fascia , Ligation , Medical Illustration , Treatment Failure , Vasectomy/instrumentationABSTRACT
Male sterilisation is less popular because of fear of loss of virility and loss of physical strength. No scalpel vasectomy is a surgical attempt to reduce complications and thereby allays the fear in the minds of the couples. Despite the introduction of the advanced technique the acceptance of male sterilisation has not gone up. Though with aggressive IEC compaign has failed to produce the desired result, but a camp based approach was successfully adopted in some states of India. Technique of no scalpel vasectomy has been summarised in the article with diagrams. Some postoperative instructions should be given to the client after discharge. No scalpel vasectomy is the gold standard for vasectomy today. Training is mandatory for experienced surgeons. Government of India funds and supports both the training and service activity.
Subject(s)
Guidelines as Topic , Humans , Male , Outcome and Process Assessment, Health Care , Postoperative Period , Minimally Invasive Surgical Procedures/instrumentation , Vasectomy/instrumentationABSTRACT
The so called myths and taboos among the people of India are obstactes controlling population explosion and thereby the nation is being handicapped with economic development. To propagate awareness and information, the NSV Resource Center took up organising mega camps for the acceptance of NSV as the method of family planning and male participation. The awareness material has been developed to bring forth total sociocultural transformation through development of intense desire, strong determination, effective management and inclusion of a zeal of perpetual efforts both among the promoters and acceptors. The information modules have been developed to suit the requirements of various vehicles through which the message has to be spread. Awareness messages are generated through the inputs from sociocultural, economic, ethical, hygienic and administrative acumen. The materials prepared are disseminated through display hoardings, wall writings, distribution of pamphlets, audiovisual clips, face to face counselling, etc. Communication technology serves mobilising and educating people, especially rural populace. Some steps are suggested to reach remotest villages which are elaborated. Counselling is an essential part of motivation to the client. During the last 5 years a significant surge has been noticed in terms of access to new communication technologies. This may be employed to successfully implement the family planning programme.
Subject(s)
Awareness , Counseling , Family Planning Services , Folklore , Health Knowledge, Attitudes, Practice , Humans , India , Male , Taboo , Vasectomy/instrumentationABSTRACT
The author looks into the comparatively newly introduced procedure of 'no-scalpal vasectomy' as it is practiced in Orissa, compares it with the conventional vasectomy and other methods of sterilisation in terms of advantages and gives the outline of the NSV procedure along with postoperative advice in a brief manner.
Subject(s)
Developing Countries , Family Planning Services , Follow-Up Studies , Forecasting , Humans , India , Laparoscopy/methods , Length of Stay , Male , Pain, Postoperative/physiopathology , Population Control , Sterilization, Reproductive/standards , Minimally Invasive Surgical Procedures/methods , Vasectomy/instrumentationSubject(s)
Animals , Dogs , Electrosurgery/instrumentation , Male , Sterilization Reversal , Vasectomy/instrumentationSubject(s)
Animals , Dogs , Epididymis/cytology , Male , Testis/cytology , Vasectomy/instrumentationABSTRACT
In 17 cases of vasectomy, the external diameter of vas deferens was found to be 2.07 +/- .27 mm (Mean +/- S.D.) with a range from 1.7 to 2.8 mm. The internal diameters were 0.93 +/- 0.13 at 5 g and 1.24 +/- 0.16 mm at 100 g insertion force applied to the measuring cone, with lumen ranges from 0.7 to 1.2 and 1.0 to 1.7 mm, respectively. The left-right variations in the same inidividual were of a similar order as between different individuals. Measurements in 6-10 kg rhesus monkeys revealed an internal vas diameter around 0.6 mm with the measuring cone only eased in. At considerably high pressure the vas could be distended to show an internal diameter around 1 mm. The external diameters ranged from 1.5 to 2 mm. Local application to the vas in vivo or in vitro of alpha or beta adrenergic blocking agents, and sodium nitrate had no appreciable effects on the diameters. Three types of valves were developed and tested. The tap-like and the rotary valves were not satisfactorily leak-proof. But the valve with stop-cock mechanism was found to be satisfactory. It was further tested by examining the ejaculate obtained by the method of electro-ejaculation after implanting the valve in the monkey vas. The stop-cock valve is being proposed as a working model for producing reversible vas-occlusion.