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

More documents

Recommendations

Info

FIGURE 18. Spreading the tissues to make askin opening twice the diameter ofthe vasLeft handPITFALLS: Watch out for two pitfalls whenspreading the tissues. First, if you fail toopen the blades of the forceps transversely ata right angle to the vas, one blade could slipout of the puncture site. This could cause anunnecessary skin tear. Second, be sure toapply appropriate counterforce to preventthe dissecting forceps from slipping out ofthe puncture hole. Maintain depth of puncture,but do not push down further than theoriginal puncture.34 No-Scalpel Vasectomy: Illustrated Guide EngenderHealth
FIGURE 19. Piercing the wall of the vas with the tip ofthe lateral blade of the dissecting forcepsLeft handDissectingforcepsScrotalskinExternalfasciaVas wallVas lumenDeliveringand Elevatingthe Right VasRemove the dissecting forceps from the puncturehole. With the tip of the lateral blade of thedissecting forceps facing downward, pierce the wall ofthe vas deferens at a 45-degree angle (Fig. 19). (Seethe box on page 32 for the definition of “lateralblade.”) Use of the lateral blade enables the operatorto rotate his or her wrist more easily.EngenderHealth Surgical Approach and Occlusion of the Vasa 35
Page 1 and 2: NO-SCALPELVASECTOMYAn Illustrated G
Page 3 and 4: ContentsPreface to the Third Editio
Page 5 and 6: Figures1 Ringed clamp 72 Dissecting
Page 7 and 8: Preface tothe Third EditionVasectom
Page 9 and 10: AcknowledgmentsThe first edition of
Page 11 and 12: IntroductionThe purpose of this gui
Page 13 and 14: vasectomy focused on experienced va
Page 15 and 16: 1FacilitiesVasectomy can be perform
Page 17 and 18: 2Instrumentsand SuppliesThe no-scal
Page 19: TABLE 2. Instruments and supplies n
Page 22 and 23: Many of these conditions can be tre
Page 25 and 26: 4AnesthesiaGood local anesthetic te
Page 27 and 28: FIGURE 4.The three-finger technique
Page 29 and 30: FIGURE 6. Side view of the skin whe
Page 31 and 32: HINT: When the needle is in proper
Page 33 and 34: FIGURE 9.Anesthesia technique:Deep
Page 35 and 36: 5Surgical Approachand Occlusionof t
Page 37 and 38: eleasing it. Use the fingers of the
Page 39 and 40: ALTERNATIVE: Instead of the tight-s
Page 41 and 42: FIGURE 16. Piercing the skin with t
Page 43: FIGURE 17. Inserting both tips of t
Page 47 and 48: dissecting forceps with the right h
Page 49 and 50: deliver the vas while the ringed cl
Page 51 and 52: Puncturingand Strippingthe SheathWi
Page 53 and 54: Occludingthe Right VasNow occlude t
Page 55 and 56: FIGURE 29. Steps in completing vase
Page 57 and 58: FIGURE 30. The completed fascial in
Page 59 and 60: FIGURE 33. Sometimes a segment ofth
Page 61 and 62: Applyingthe RingedClamp to theScrot
Page 63: APPENDIXAND REFERENCES
Page 66 and 67: Sterilization does not protect agai
Page 69 and 70: ReferencesAlderman, P. M. 1991. Com

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

Create successful ePaper yourself

Delete template?

Save as template?