This document provides information on the procedure for vasovasostomy and cutaneous vasostomy. Vasovasostomy involves recannulization of the vas deferens to restore fertility by excising scar tissue from both ends of the vas deferens and anastomosing the vas under magnification. Cutaneous vasostomy involves incising a loop of the vas deferens and suturing it to the scrotal skin to drain an infected epididymis or testis. Both procedures require preparing and draping the patient, using microscopes and fine suture materials, and applying dressings after closing the wound.

1. VASOVASOSTOMY
Presented by----
Mrs. Usha Rani Kandula,
MSc.Nursing, Assistant professor,
Department of Adult Health Nursing,
College of Health Sciences,
Arsi University, Asella, Ethiopia.

2. DEFINITION
-Recannulization of the vas deferens for the
restoration of fertility requires an
unobstructed anastomosis.

12. PROCEDURE
-A scrotal incision exposes the vas deferens
above and below the site of the previous
ligation.
-A needle biopsy,
-or preferably incisional testicular biopsy, may
be performed.

13. -Under magnification,
-scar tissue is excised from both ends of the
vas and the vas is mobilized to avoid tension
on the ananstomosis.

14. -Care is taken to avoid undue trauma to the
local blood supply.
-The wound is closed.
- A bulky dressing is applied.
-For Preparation of Patient, Skin Preparation,
and Draping, see Vasectomy,.

15. DRAPING
-Add microscope cover, as necessary.
EQUIPMENT
-ESU
-Magnifying loupes or microscope, as
requested

16. INSTRUMENTATION
-Limited procedures tray
MICROSCOPIC INSTRUMENTS:
-Tissue forceps (1),
-curved smooth forceps (2),
-curved tying forceps (1),
-Castroviejo needle holder (1),
-vas holding forceps (1)

17. SUPPLIES
-Antiembolitic hose
-Small basin
-Blades, (1) #15 and (1) #11
-Needle magnet or counter

18. -Electrosurgical pencil with needle tip
-Suture (fine), e.g., 9-0 and 10-0 nylon
-Dressing, e.g., telfa, “gauze fluffs,” and scrotal
support
-Ice pack (as requested)

19. SPECIAL NOTES
-Apply Special Notes from Abdominal
Laparotomy, as indicated.
-Arrangement of all needed equipments.

20. CUTANEOUS VASOSTOMY
DEFINITION
-Establishment of an opening of the vas onto
the scrotal skin.

21. Cutaneous vasostomy
-Cutaneous vasostomy is performed to drain an
infected epididymis or testis by incising a
loop of the vas and suturing it to the scrotal
skin.

22. Vasography
-The wound or wounds usually close
spontaneously after the precipitating episode
subsides.
-Vasography may be done by injection of
contrast media into the severed end(s) of the
vas.

23. PROCEDURE
-An incision is made over the vas;
-the vas is grasped and freed of surrounding
tissue.
-The vas is divided,
-and the severed ends are sutured to the scrotal
skin.
-A bulky dressing is applied.

24. -For Preparation of the Patient,
-Skin Preparation,
-Draping,
-Equipment,
-Instrumentation,
-Supplies,
-and Special Notes, see Vasectomy, .
THANKING YOU.