Robotic assistance in urological microsurgery: initial report of a successful in-vivo robot-assisted vasovasostomy

Naeyer, Geert De; Migem, P. Van; Schatteman, Peter; Carpentier, Paul; Fonteyne, E.; Mottrie, Alexandre

doi:10.1007/s11701-007-0025-y

Cited by 12 publications

(6 citation statements)

References 8 publications

(7 reference statements)

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“… 8 Relatively recently, the robotic platform was applied to VR in humans and may offer some potential advantages. 9 10 11 12 13…”

Section: Introductionmentioning

confidence: 99%

Validation of robot-assisted vasectomy reversal

Kavoussi

2015

Asian J Androl

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Vasectomy reversal (VR) has traditionally been performed with the operative microscope. Recently, robot assistance has been applied to VR. Retrospective chart review from a single VR center included men who underwent either robot-assisted VR (RAVR) or microsurgical VR (MVR) by a single fellowship trained microsurgeon between 2011 and 2013 and had a 6 weeks postoperative semen analysis. Fifty-two men who were interested in VR were counseled and given the option of RAVR versus MVR. Twenty-seven men elected to have MVR while 25 men elected RAVR. These included vasovasostomies and vasoepididymostomies in both groups, as well as redo VRs in men who had failed previous VR attempts by other surgeons. There was no statistically significant difference between the microsurgical group and the robot-assisted group, respectively, in overall patency rates (89% vs 92%), 6 weeks post-VR mean sperm concentrations (28 million ml−1 vs 26 million ml−1) or total motile counts (29 million vs 30 million), or mean operative times (141 min vs 150 min). There was a statistically significant difference in anastomosis time (64 min vs 74 min), however, clinically this only represented a 10 min longer anastomosis time in the early robotic experience, which was found to be decreasing as the case series continued. Transitioning from MVR to RAVR is feasible with comparable outcomes.

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“… 8 Relatively recently, the robotic platform was applied to VR in humans and may offer some potential advantages. 9 10 11 12 13…”

Section: Introductionmentioning

confidence: 99%

Validation of robot-assisted vasectomy reversal

Kavoussi

2015

Asian J Androl

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“…In 2004, in vivo RAVV on 2 patients was first reported . Another group reported the details of the RAVV operation on a 34 year old man by using the da Vinci robotic system for a VR . They reported that the vasovasal anastomosis was performed by using a 1‐layer technique with a single‐armed 8‐0 Prolene suture.…”

Section: New Inventions In Microscopic Vasovasostomy and Vasoepididymmentioning

confidence: 99%

Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decade

Namekawa

Igarashi

Kato

et al. 2018

Reprod Medicine & Biology

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BackgroundIn the era of improving assisted reproductive technology (ART), patients with obstructive azoospermia (OA) have 2 options: vasal repair or testicular sperm extraction with intracytoplasmic sperm injection. Vasal repair, including vasovasostomy (VV) and vasoepididymostomy (VE), is the only option that leads to natural conception.MethodsThis article reviews the surgical techniques, outcomes, and predictors of postoperative patency and pregnancy, with a focus on articles that have reported over the last 10 years, using PubMed database searches.Main findingsThe reported mean patency rate was 87% and the mean pregnancy rate was 49% for a patient following microscopic VV and/or VE for vasectomy reversal. Recently, robot‐assisted techniques were introduced and have achieved a high rate of success. The predictors and predictive models of postoperative patency and pregnancy also have been reported. The obstructive interval, presence of a granuloma, and intraoperative sperm findings predict postoperative patency. These factors also predict postoperative fertility. In addition, the female partner's age and the same female partner correlate with pregnancy after surgery.ConclusionIn the era of ART, the physician should present and discuss with both the patient with OA and his partner the most appropriate procedure to conceive by using these predictors.

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“…Ultimamente è stato proposto l'impiego del robot (Da Vinci, Intuitive ) per l'esecuzione di vaso-vasostomie ed epididimo-vasostomie (34–36). L'ingrandimento visivo fornito dall'ottica robotica è sufficiente per eseguire l'intervento che utilizza le medesime tecniche chirurgiche descritte sopra.…”

Section: Ricanalizzazioni Delle Vie Seminali Prossimali E Distaliunclassified

Surgery of male infertility: An update

et al. 2014

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Surgery for male infertility includes three main areas: varicocele surgery, recanalization of seminal tract, sperm retrieval.Varicocele treatment in infertily is still controversial. Recent scientific evidence appears to demonstrate that in selected cases varicocele treatment is beneficial in improving semen parameters and pregnancy rate. The key for the success of treatment seems to be a correct indication. It is our opinion that varicocele should be treated in presence of abnormal semen parameters, when clinically significant, and in adolescents with atrophy of the affected testis. So far, no specific technique, either surgical, microsurgical or sclerotherapic, can be considered the gold standard. Good results in our hands have been obtained with the microsurgical lymphatic sparing high ligation of internal spermatic vein.Innovations in surgery for seminal tract obstructions include the new tubular invagination techniques for epididimovasostomy, which showed excellent results with a simplified and time-saving microsurgical approach. In distal obstructions, a new transperineal ultrasound-guided approach has been proposed for the diagnostic work-up and treatment. Advantages of this technique and of the TURED must be balanced with those of immediate sperm retrieval for ART.In sperm retrieval, microTESE represents the most important surgical evolution in non-obstructive azoospermia. We have recently proposed a new stepwise approach starting with a minimal equatorial incision for conventional testicular biopsy which is extended to perform microTESE only when no sperm is retrieved. In this way microTESE is offered only to patients who really need it. Another field of innovation is sperm retrieval for ICSI in patients with Klinefelter Syndrome.

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Robotic assistance in urological microsurgery: initial report of a successful in-vivo robot-assisted vasovasostomy

Cited by 12 publications

References 8 publications

Validation of robot-assisted vasectomy reversal

Validation of robot-assisted vasectomy reversal

Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decade

Surgery of male infertility: An update

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