Clinical Application of 24 G Cannula Needle and 3-0 Polypropylene Suture in Vas Deferens Exploration

Summary

This protocol presents the clinical application of a 24 G cannula and 3-0 polypropylene suture as a simple and effective method for the exploration of the vas deferens.

Abstract

The goal of this article is to present the application of a 24 G cannula and 3-0 polypropylene suture as a simple method for the exploration of the vas deferens. During the exploration of the vas deferens, a 24 G cannula needle was used to puncture it. The fluid in the smear confirmed the presence of sperm, to determine whether or not there was concomitant obstruction at the junction of the epididymis and the vas deferens. Then, a 3-0 polypropylene suture (this suture specification has the advantages of a smooth surface, robust quality, and can be passed through a 24 G cannula needle) was passed through the cannula needle to probe the location of the obstructed site. With this technique, exploration of the vas deferens could be more targeted and accurate.

Introduction

Microsurgical vasovasostomy (MVV) is a common treatment for vas deferens obstruction after herniorrhaphy in childhood^1,2. The site of obstruction cannot be identified preoperatively, and it is not clear whether sperm are present in the vas deferens or not. This may lead to difficulty in selecting the incision and injury to the vas deferens during semi-open exploration, which decreases the success rate of anastomosis, prolongs the operation time, and increases the risk of abdominal exploration^3,4.

Injury to the vas deferens ....

Protocol

All methods described here were approved by the Ethics Committee of Union Hospital Tongji Medical College, Huazhong University of Science and Technology. We obtained the patient's consent to use his surgical footage as a video after the procedure.

1. Instruments for operation

1. Ensure the availability of a surgical microscope system, microsurgical instrument, and microscopic bipolar electrocoagulation.

2. Preparation for operation

1. Inclusion criteria
   1. Include all patients diagnosed with azoospermia who agree to undergo surgery. Have all ....

Results

There were 67 patients enrolled in the study. As shown in Table 1, the mean age of the patients was 28.8 ± 3.7 years (range: 23-45 years). The time since herniorrhaphy was 24.5 ± 3.2 years (range: 21-43 years). The female partners were 25.2 ± 3.2 years (range: 23-42 years) years old. A total of 11 (16.4%) patients had pain in the scrotum. Four patients (6.0%) were underweight (BMI < 18.5 kg/m²), 53 (79.1%) had normal weight (BMI 18.5-24.9 kg/m²), eight (11.9%) were overweight (BM.......

Discussion

As mentioned before, the location of the vas deferens stump cannot be determined at the inguinal incision, which requires exploration of the original inguinal incision. In this study, we can use this simple operation to determine the site of obstruction and make surgical decisions. If the site of obstruction is in the original incision, MVV can be considered. If the vas deferens injury is not found in the inguinal canal, we can use lapa-VV or SV.

When pasty fluid without sperm was found and th.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
0.9% sodium chloride solution	Guangdong Otsuka Pharmaceutical Co. LTD	21M1204	Inject into the vas deferens
1% iodophor	Guangzhou Qingfeng Disinfection Products Co., LTD	Q/QFXD2	Skin disinfection
24G cannula needle	Suzhou Linhua Medical Instrument Co., LTD	20193141896	Size:24G, Type:Pen type, with wings, with injection port, Y type
3-0 monofilament polypropylene	Covidien Medical Equipment international trading (Shanghai) Co., LTD	DOL2861y	Taper Point, Size 3-0, Blue, 36", Needle V-20, 1/2 Circle
5 mL syringe	Kindly Medical, Shanghai	K20210826	Inject 0.9% sodium chloride solution into the vas deferens
F16 Catheter	Guangzhou Weili Co., Ltd	20190612	Drainage of urine
micro haemostatic forceps	Shanghai Medical Instrument (Group) Co., LTD.	W40350	Used in surgical procedures
micro scissors	Shanghai Medical Instrument (Group) Co., LTD.	WA1010	Used in surgical procedures
micro tweezers	Shanghai Medical Instrument (Group) Co., LTD.	WA1020	Used in surgical procedures
Olympus microscope	Olympus Corporation	Scipu001158	4×N.A.0.10 W.D.22.0mm     10×N.A.0.25 W.D.10.5mm       40×N.A.0.65 W.D.0.56mm     100×N.A.1.25 W.D.0.13mm
Operating microscope system	Carl Zeiss Co., Ltd	OPMI VARIO 700