Microsurgery for Fertility Specialists: A Practical Text by Philip S. Li M.D., Ranjith Ramasamy M.D. (auth.), Jay I.

By Philip S. Li M.D., Ranjith Ramasamy M.D. (auth.), Jay I. Sandlow (eds.)

Microsurgery for Fertility Specialists is a useful source for physicians who focus on the surgical procedure of female and male infertility. This sensible textual content explains the fundamentals of microsurgery and offers special operative descriptions of surgeries corresponding to vasectomy reversal, sperm retrieval, tubal reanastomosis, and penile surgical procedure. a superb cadre of reproductive experts stocks invaluable wisdom of the present country of microsurgery, its function in infertility approaches, and the most recent advances within the box --including a few non-infertility microsurgical innovations. The e-book is an important academic advisor for people with a extra complicated wisdom of microsurgical perform because it contains chapters that may support them mentor citizens and fellows, and encourage destiny generations of reproductive surgeons.

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Crain DS, Roberts JL, Ambling CL. Practice patterns in vasectomy reversal surgery: results of a questionnaire study among practicing urologists. J Urol. 2004;171:311–5. 3. Silber SJ. Epididymal extravasation following vasectomy as a cause for failure of vasectomy reversal. Fertil Steril. 1979;31:309–15. 4. Chawla A, O’Brien J, Lisi M, Zini A, Jarvi K. Should all urologists performing vasectomy reversals be able to perform vasoepididymostomies if required? J Urol. 2004;172:1048–50. 5. Belker AM, Thomas Jr AJ, Fuchs EF, Konnak JW, Sharlip ID.

Some surgeons find a fine Detrich right angle useful for blunt dissection as well. Microsurgical forceps are a necessity; we prefer the 8″ Pierse microsurgical forceps. We prefer to isolate the vas and vasal vessels first (Fig. 8), as to avoid inadvertent later injury to these vital structures. Microdissection is then performed to isolate the internal spermatic arteries, during which obvious veins are double ligated with 4-0 silk ties or vascular titanium clips (Horizon™) and sharply divided using Westcott scissors.

7 A 20 MHz microvascular Doppler (Vascular Technology—Nashua, NH) is used to survey the cord for arteries 1:5 ratio with saline to the operative field via a 5 cc syringe with 24 G angiocatheter will help dilate the arteries to aid in Doppler identification. Technical Pearls The goals of cord dissection are to: (1) identify and preserve the vas deferens and vasal vessels, (2) identify and preserve any internal spermatic arteries, (3) preserve adequate lymphatic channels, and (4) ligate and divide any veins of the pampiniform plexus and preferably cremasteric layer as well.

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