January 9, 2010

Reversing Vasectomies–There’s A Bot For That

Fertility and Babbys, News No Comments

Urologists at the University of Florida are using robots to reverse vasectomies, effectively shaving off 20 minutes of surgery time from the procedure. Not only does this spare surgeons’ backs, as they have to be bent over a patient operating with high-power microscopes, but it appears that the decreased time spent in surgery enables sperm count in patients to return faster.

“For a couple that’s trying to get pregnant, this is a big deal,” said Dr. Sijo Parekattil, director of male infertility and microsurgery at the University of Florida, who led the study, soon to be published in the Journal of Endourology.

Many types of surgery are now being aided by robots, and surgeons continue to explore new areas in which they can be used.

“This is state-of-the-art stuff, it’s cutting-edge, and a stepping stone to understanding whether or not we can use this technology on a more widespread basis,” said Dr. Wayne Kuang, director of Male Reproductive Health at University of New Mexico, who was not involved in the study. “It’s a natural progression from back in the days when we just had magnified eyeglasses.”

But vasectomy reversal via bot is not without controversy: many specialists believe that developing an expensive robot to do something that’s already done with a microscope is a waste of resources and that the costs associated for patients (a bot-assisted reversal is $3,000 more than a conventional vasectomy reversal).

“The big question is did it improve outcomes — either pregnancy rates or the time spent in surgery?” said professor Dr. Jay Sandlow, vice chair of the department of urology at Medical College of Wisconsin in Milwaukee, who initially had reservations about the robotic procedure but after seeing the preliminary results now says he sees value in the method.

“It certainly looks as if he has done that,” said Sandlow, who was not involved in the study. “He has shown a meaningful decrease in the amount of time it takes to do these robotically compared to the open procedure.”

It’s also worth noting that since many hospital fees are based on time, cutting down on operating time could offset some of the cost of using the robot.

It is too soon to tell whether pregnancy rates have improved since the conclusion of the 2009 study that compares the results of 20 men who had the robotic procedure and the seven who had the microscopic one.

But two months after surgery, average sperm count in the robotic surgery group was 54 million, compared with 11 million in the microscopic surgery group. Early results show that the difference in sperm count between the two procedures decreases over time, however.

Information from the University of Florida.

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