No Scalpel vasectomy

No-scalpel vasectomy (also called keyhole vasectomy) is a vasectomy procedure in which a sharp hemostat is used to puncture the scrotum.^[1] This method is widely used in over 40 countries for permanent male sterilization. As opposed to conventional vasectomy, this procedure carries clinically significant lower risk of surgical complications.

Procedure

No-scalpel vasectomy was developed in China by Dr. Li Shunqiang with the aim of reducing men’s fear related to the incision and increasing vasectomy use in China. Over time, the technique gained popularity and it is now a preferred method of male sterilization in many countries. The procedure is done under local anesthesia, usually in an outpatient clinic. Certain diseases of the male genital system, including infections, filariasis and large hydrocoele are contraindications for no-scalpel vasectomy. These diseases should be treated before no-scalpel vasectomy is performed. The vas is isolated by three-finger technique on both sides. The ideal entry point for the needle is midway between the top of the testes and the base of the penis. Usually, 100 mg lidocaine (without epinephrine) is injected to create a wheal. Afterwards, a ringed clamp is used to puncture the scrotal skin and elevate the vas deferens. A dissecting forceps is used to spread the tissue, pierce the wall of the vas and deliver it outside. It is then occluded and ligated.^[2] This procedure has less pain, bleeding and infection than conventional vasectomy. NSV can be done in less time and the individual is able to return to sexual activity sooner than traditional vasectomy surgery.

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