Is Robotic Vasectomy Reversal different from standard microsurgery?
Yes. We utilize the latest davinci robotic platform as a substitute for the standard microscope to perform a high end microsurgical vasectomy reversal. We perform a 3 layer anastomosis or connection using 10-0 and 9-0 nylon sutures (suture that is even finer than human hair). The procedures are done under mild anesthesia to maximize your comfort and ensure a quality outcome.
The use of robotic assistance allows for enhanced magnification, elimination of surgeon tremor, motion scaling and decreased surgeon fatigue. The robot is a tool our fellowship trained surgeons use for surgical precision and dexterity. The robotic system acts as an instrument to extend the capabilities and range of motion during complex microsurgical maneuvers. Since the platform offers an additional instrument arm that is controlled by the surgeon, it also allows for the surgeon to be less reliant on the surgical assistant and provides complete control of the field to the surgeon – every instrument movement is controlled by the primary surgeon.
Performing such procedures, like robotic vasectomy reversal, requires specialized expertise. Our urologists are fellowship trained microsurgeons. Our surgeons have performed over 1,000 robotic microsurgical procedures and are the global leaders in this field. They have performed more robotic microsurgical procedures than any other center in the world.
What is the Success Rate for Robotic Vasectomy Reversal?
Success rates after microsurgical vasectomy reversal can depend on several factors which include how many years it has been since the patient’s previous vasectomy, scarring within the tubes, and patients age. The highest success rates are encountered in patients within 3 years of their vasectomy. As the time interval from the vasectomy increases, the success rate decreases slightly. We have had successes in men who have had vasectomies 38 years ago. Our most recent database review published a high 90+% success rate for bilateral vasovasostomy cases.
What is the Cost of a Vasectomy Reversal?
The total charge for our Robotic Microsurgical Vasectomy Reversal is $7,500 at South Lake Hospital (near Orlando). These charges include hospital, anesthesia & surgical fees (excludes post-op semen analysis tests). We do all our reversals under anesthesia in the hospital to maximize your comfort and safety. Some patients may have a secondary blockage in the epididymis, which is the storage container for sperm located behind the testicle. This blockage occurs more frequently in men who are further out from their vasectomy. Thus, at the time of reversal, our team microscopically examines the fluid that comes out of the proximal vas (end of vas coming from the testicle) for sperm.
If there is an epididymal blockage, there will be no sperm and thus, the distal end of the vas needs to be connected directly to the epididymal tubule above the level of obstruction. This is a more complex type of reversal called vaso-epididymostomy. We do not charge anything additional for the complex reversal and will decide on the type of reversal (vaso-vasostomy vs. vasoepididymostomy) at the time of surgery. We perform the best reversal for the patient based on what they need at that time.
Novel Bio-wrap Vasectomy Reversal Option
We also offer an adjunct to your reversal utilizing a bio-wrap with the potential to reduce scarring, granuloma formation and any possible auto-immune reactions at the reversal site (the bio-wrap costs $1000 additional – this is the cost of the material).
Cryo-Preservation of Sperm at the time of Vasectomy Reversal
We also offer the option to cryo-preserve sperm at the time of the reversal for future IVF (assisted reproductive technique) use in case the reversal does not succeed. This is an additional cost (please call the office to get details) and can be arranged with advanced notice to our office (we need a few weeks advanced notice to arrange for this). This is usually only recommended for patients who are undergoing a redo vasectomy reversal or are several years out from their original vasectomy.
Vasectomy Reversal for Chronic Groin, Testicular or Post-Vasectomy Pain?
In a small percentage of men who have previously undergone a vasectomy, there may be chronic testicular and/or groin pain. This pain can range from mild irritation to debilitating pain that requires chronic pain medication use. In some of these men with specific findings of episodic pain, especially after ejaculation, or episodic pressure sensations, vasectomy reversal may be a treatment option. We have a testicular pain and/or groin pain clinic dedicated to the treatment of men with this condition and have a number of treatment options, including:
- Mapped segmental spermatic cord blocks
- Robotic assisted microsurgical targeted denervation of the spermatic cord
- Robotic assisted microsurgical vasectomy reversal with biowrap
- Targeted Micro-Cryoablation of the peri-spermatic cord
- Targeted Botox Block of the peri-spermatic cord
Peer Reviewed Publications on our Vasectomy Reversals
- Parekattil SJ, Gudeloglu A, Brahmbhatt J, Wharton J, Priola KB: Robotic Assisted Verses Pure Microsurgical Vasectomy Reversal: Technique & Prospective Database Cohort Trial. Journal of Reconstructive Microsurgery, Sept 2012.
- ParekattilSJ, Brahmbhatt JV:Robotic approaches for male infertility and chronic orchialgia microsurgery. Curr Opin Urol. 2011 Nov;21(6):493-9.
- Parekattil SJ, Cohen MS: Robotic microsurgery 2011: male infertility, chronic testicular pain, postvasectomy pain, sports hernia pain and phantom pain. Curr Opin Urol. 2011 Mar;21(2):121-6.
- Parekattil SJ, Cohen MS: Robotic Microsurgery in Male infertility and Chronic Orchialgia. Curr Opin Urol. 2010 Jan;20(1):75-9. Review.
- Parekattil SJ, Atalah HN, Cohen MS. Video technique for human robotic assisted microsurgical vasovasostomy. J Endourol. 2010 Apr;24(4):511-4.