I have been using titanium heamoclips for five years now, one on each side. The testicular end of the severed vas is first ‘milked’ down into the fasciasheath. The clip is then applied accross the sheath to keep the testicular end of the vas locked away . While applying the clip in this fashion it also often happens that I pinch off much of the artery to the vas, the bane of every vasectomist’s life. In this way homeostasis is greatly enhanced.
Up until last week, this ‘new’ approach to performing vasectomies was most impressive. I even wrote a paper on the subject showing how statistically results were so much superior to using suture and cautery. Failed vasectomy seemed to be a thing of the past and post-operative haematoma seemed to be a thing of the past. And then — bank. Reality suddenly struck. The phone-call from a distraught wife that evening said it all as she discribed in all its gory detail the classic symptoms of intrascrotal bleeding. Disaster!
Within a few hours I had organised my poor man to be seen by a Urological colleague who evacuated the clot. And within another few days of that he was up and about again, bloodied but unboughed. But the incudence has shuck me badly and rattled my confidence, at least for the moment. The old addage has been vindicated. Nothing in surgery is ever 100%