Robotic Vasectomy Reversal: An American Perspective

This chapter reviews the history of robotics in the field of microsurgery and the assessment and treatment of men in the United States who have undergone vasectomy and are interested in vasectomy reversal to reestablish fertility and to father children, as well as the application of robot assistance to this procedure. The role of robot assistance in vasectomy reversal is for the potential of replacing the operative microscope with potential advantages for the reproductive microsurgeon. For optimal outcomes with the application of the robotic platform to microsurgery, it is necessary to have a high level of training and skill in microsurgical techniques. A number of potential advantages may be gained by applying robotics to microsurgery including improved stability, decreased surgeon fatigue by improving ergonomics, removing the impact of a physiologic tremor, high-definition three-dimensional optics, scalability of motion, allowing the surgeon to control instrumentation with a camera and three microsurgical instruments concomitantly, foregoing the need for a specialty skilled microsurgical assistant, and the potential for improving operative times.