Scrotal Surgery



Who chooses vasectomy?





Procedure Steps

  1. Check to make sure vas are palpable
  2. Prep/drape patient
  3. Isolate vas w/ middle finger behind w/ non-dominant hand
  4. Inject local in skin and vas
  5. Make scalpel incision over vas, can be transverse or longitudinal
  6. Dissect layers down onto vas
  7. Push ring clamp down onto vas, open and clamp w/ force to prevent vas “escape”
  8. Once vas obtained, can inject local proximal/distal
  9. Use dissector to isolate vas from surrounding layers, can also cut off with scalpel
  10. Once vas isolated, clamp proximal and distal
  11. Excise portion of vas, send to pathology
  12. Perform mucosal cautery
  13. Ligature each end w/ 2-0 silk tie, can stitch through vas
  14. Keep tails long
  15. Assess for hemostasis, then return vas to scrotum
  16. 3-0 chromic horizontal mattress suture
  17. Apply bacitracin, scrotal support

Vas isolation tips

Vas occlusion tips

Normal expectations

Post-Vasectomy Semen Analysis (PVSA)