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Use of surgical clips prevents suture slippage when ligating folded vas deferens during vasectomy

Miriam Hadj-Moussa, James A. Brown

Division of Urology, Medical College of Georgia, Augusta, Georgia, USA
Address correspondence to Dr. James A. Brown, University of Iowa, Department of Urology, 200 Hawkins Drive, 3 RCP, Iowa City, IA 52242-1089 USA

Canadian Journal of Urology 2010, 17(3), 5213-5215.

Abstract

Objective: We describe a technique of surgical clip placement, which prevents slippage when ligating the folded vas deferens during vasectomy.
Methods: We utilized this technique in 25 consecutive vasectomy procedures. After isolating the vas, two mosquito clamps are placed approximately 2 cm-3 cm apart and a small 5 mm-10 mm section of full thickness vas is removed. The lumen of each cut end is cauterized. Surgical clips (Ethicon Ligaclip Extra LS-200, Medium) are placed at approximately 2 mm, 3 mm and 15 mm (on the opposite side of the hemostat) from each cut end. By rotating the hemostat, the vas is folded on itself and a 3-0 or 4-0 chromic suture is placed between the two proximal clips and distal to the third clip. The hemostat is carefully removed and the vas gently ligated.
Results: A single surgeon noted no instances of suture slippage in 25 consecutive vasectomies. All patients underwent postoperative semen analysis that showed azoospermia.
Conclusion: Placement of the ligating suture between two proximal clips and past a third distal clip prevents suture slippage when ligating the folded end of the vas deferens during vasectomy.

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