NO-SCALPEL VASECTOMY

NO-SCALPEL VASECTOMY

No-scalpel vasectomy was developed and first performed in China in 1974 by Dr. Li Shunqiang of the Chongqing Family Planning Scientific Research Institute, located in Sichuan Province.

No-scalpel vasectomy results in fewer hematomas and infections than does conventional incisional vasectomy Men undergoing no-scalpel vasectomy reported less pain during the procedure and early in the follow-up period than did men having an incisional vasectomy,

and also reported earlier resumption of sexual activity after surgery (Skriver, Skovsgaard, & Miskowiak, 1997; Sokal et al., 1999).

Instruments and Supplies

The no-scalpel technique requires two instruments specially designed by Dr. Li Shunqiang.

1. The extracutaneous ringed forceps is a type of clamp used to fix the vas deferens . For the sake of clarity, the term ringed clamp will be used throughout this manual. Throughout the operation, the surgeon uses the ringed tip of this instrument to encircle and to grasp the vas, without injuring the skin.

The dissecting forceps is similar to a curved mosquito hemostat, except that the tips are

sharply pointed. It is used to puncture the scrotal skin, to spread the tissues, to dissect the sheath, and to deliver the vas deferens.

Instruments

• Ringed clamp

• Dissecting forceps

• Straight scissors

Supplies

• Adhesive tape and gauze for positioning the penis away from the surgical field (optional)

• Scissors for clipping any scrotal hair that would interfere with the procedure

• Soap and water or antiseptic agents for the surgical scrub (see page 13)

• Alcohol rinse (recommended if plain soap is used for the surgical scrub)

• Sterile gloves

• Nonirritating antiseptic solution for cleaning the operative area (see page 12)

• Sterile drapes

• 10-cc syringe with a 11.2-inch, 25- or 27-gauge needle (U.S. system)

• 1% or 2% lidocaine without epinephrinea

• Supplies for vasal occlusion according to the surgeon’s preference (examples: a cautery unit; chromic catgut or nonabsorbable silk or cotton for ligation) • Sterile gauze

• Adhesive tape or Band-Aid for dressing the wound

• Scrotal support for the man to wear after the procedure (optional)

Before any vasectomy is performed, the client must receive appropriate information and counseling and give his informed consent.

The following are conditions requiring a delay or special precautions:*

• Local infection—including scrotal skin infection, active sexually transmitted infection (STI),

balanitis, epididymitis, or orchitis

• Previous scrotal injury

• Systemic infection or gastroenteritis

• Large varicocele

• Large hydrocele

• Filariasis; elephantiasis

• Local pathological condition (e.g., intrascrotal mass, cryptorchidism, or inguinal hernia)

• Bleeding disorders

• Diabetes

• AIDS (HIV-positive status without AIDS is not a concern.)

* More about Dr. Li Shunqiang *