No-Scalpel Vasectomy: An Illustrated Guide for ... - EngenderHealth

4AnesthesiaGood local anesthetic technique is essential for apain-free vasectomy. It also prevents local hematomaand injury to the testicular vessels, which may resultfrom multiple blind injections. Dr. Li Shunqiang’sanesthesia procedure, which is described below,achieves both of these objectives and also has severalother advantages. The technique, which involves adeep injection alongside the vas, creates a vasal nerveblock. Conventional techniques anesthetize only thearea around the skin-entry site. Injection of theanesthetic away from the vasectomy site in thedirection of the inguinal ring helps make skin entryeasier. Care is taken when injecting the lidocaine tokeep the needle away from the internal spermaticfascia that enclose the testicular artery and veins(Fig. 3). Because the surgeon makes only a singleneedle puncture and one smooth injection for eachvas, the risk of bleeding is reduced.In a randomized trial comparing no-scalpel vasectomyto the conventional technique, men undergoingno-scalpel vasectomy with vasal block anesthesiareported experiencing less operative pain than did menundergoing conventional vasectomy (Sokal et al., 1999).FIGURE 3.Cross-section of the spermatic cordVeinsVasArteryVas lumenSkinDartosExternalspermatic fasciaCremastericfasciaCremastermuscleInternalspermatic fasciaEngenderHealth 15