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No-needle Vasectomy
Traditionally, a local anesthetic has been injected into the skin and alongside each vas tube with a very fine needle, as small as needles diabetics use to inject themselves with insulin. One could feel a tiny poke in the skin, then a bit of a squeeze as the anesthetic was applied to each vas tube. However, most people do not like needles of any size ... especially there! A special spray applicator which delivers a fine stream of liquid anesthetic at a pressure great enough to penetrate the skin to a depth of about 3/16", deep enough to envelop the vas tube held snugly beneath the skin. Each vas is positioned in turn beneath the very middle of the front scrotal wall and given two or three squirts. That numbs the skin and both vas tubes adequately for 99% of men. The other 1% (usually men who have scarring due to prior surgical procedures in the area) will require a bit more anesthetic delivered with a fine needle, usually with no pain at all because of the partial anesthesia achieved with the spray applicator.
No-scalpel Vasectomy
The no-scalpel vasectomy instruments, used in China since the mid-70's and introduced into the United States in the 80's, are simply a very pointy hemostat, used initially to make a tiny opening into anesthetized skin of the scrotal wall, and a ring clamp, used initially to secure each vas tube in turn beneath this opening. The pointy hemostat is then used to spread all layers down to the vas tube itself and to then deliver a small loop of the vas through the opening as the ring clamp is released. In turn, the ring clamp is used to hold the vas, while the pointy hemostat spreads adherent tissue and blood vessels away from the vas under direct vision, so that the vas can then be divided with a fine surgical scissors and the ends cauterized and clipped, sealing both ends close.
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Cascades Urology Center
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