A modified vasoepididymostomy performed with the sling and blanket technique.
A modification is presented for the end-to-end type of vasoepididymostomy known as the sling and blanket. We have exploited the differences in size between the vas and epididymis to gain a mechanical advantage. When the epididymis is transected the redundant tunic is preserved. The sling is created from the tunic, which is drawn forward and sutured to the vas posteriorly about 1 cm. from its cut end. The sling provides support so that the end-to-end anastomosis between the vas lumen and specific epididymal tubule may be completed in 1 plane and without rotation. The blanket is created from the remaining epididymal tunic, which is sutured anteriorly to cover the anastomosis and stabilize the vas. The procedure was performed on 8 patients with primary epididymal obstruction. The patency rate was 50% and the pregnancy rate was 25%. Although vasoepididymostomy remains a difficult microsurgical operation, this modification seems to be beneficial in selected cases.
Marmar
J L
JL
Division of Urology, Robert Wood Johnson Medical School, Camden, New Jersey.
DeBenedictis
T J
TJ
Praiss
D E
DE
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D004822:Epididymis / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009845:Oligospermia / Q000209:etiology / Q000601:surgery; D013536:Suture Techniques; D013733:Testicular Diseases / Q000601:surgery; D014649:Vas Deferens / Q000601:surgery*