Male bariatric reversal

Male family planning surgery is mainly to prevent the discharge of sperm, that is, vasectomy. In addition, it also includes the treatment of re-cultivation after infertility or sterilization, that is, vas deferens anastomosis and vas deferens epididymal anastomosis. Vas deferens surgery refers to the use of surgical or non-surgical procedures to cause spermatic tract blockade. After the testis can still continue to produce sperm, mature sperm dissolved in the epididymis, there is still a normal ejaculation process during sexual intercourse, but there is no sperm in the semen. The vas deferens sterilization is simpler, safer, and has no complications of abdominal surgery than the fallopian tube birth control. The postoperative recovery is also faster. Therefore, it is currently the main birth control measure. The vas deferens sterilization includes cutting off the vas deferens, occluding the vas deferens by means of chemical or electrocoagulation, blocking the vas deferens in the lumen, or closing the vas deferens outside the tube. Currently, the most commonly used is vasectomy, followed by vas deferens occlusion. The male stagnation technique is mainly suitable for those who require vas deferens for various reasons after vasectomy. The vas deferens is thinner and it is difficult to match. If microsurgical techniques can be applied, the success rate is greatly increased. Treating diseases: oligozoospermia Indication 1. After vasectomy, special fertility needs to be born after special reasons. 2. Non-surgical treatment of epididymal deposition after sterilization is not effective. 3. Sexual dysfunction caused by mental factors after sterilization is not effective by multiple treatments, and there are no surgical contraindications. 4. Trauma or accidental injury to the vas deferens. 5. The vas deferens obstructive azoospermia. Contraindications 1. The general health condition is poor and cannot tolerate surgery. 2. Local or reproductive system inflammation has not been cured. Preoperative preparation 1. Explain to the subject and family members the success rate of anastomosis, including recanalization rate, re-pregnancy rate, re-incubation rate and possible complications. Both parties are informed and sign the consent form. 2. Ask the medical history in detail to find out what kind of vasectomy has been done, whether it has done men's recanalization and the time and postoperative conditions. 3. Do a full physical examination. Check blood routine, urine routine, clotting time, and if necessary, do related auxiliary examination. Focus on the genitourinary system and semen routine to understand whether it is appropriate for surgery, to determine the operation and anesthesia. 4. For local skin preparation, the perineal part should be washed once a day on the 2nd day before surgery. After the genitals are prepared, wash the lower abdomen, penis, scrotum and perineum with warm water and soap. 5. With local infiltration anesthesia with procaine, a skin test should be performed. Surgical procedure 1. The surgeon wears surgical underwear, wears a hat, a mask, and wears sterile gloves after routine brushing. 2. Position in the supine position, the two lower limbs are slightly separated. 3. Spread the sterile towel and cover with a sterile hole towel to expose the surgical field. 4. Incision, separation of the vas deferens The skin scar of the vasectomy is removed, and the incision is enlarged to 2 to 3 cm. The distal and proximal ends of the vas deferens are clearly separated, and the ends are lifted by sutures. Then, the vas deferens are separated to the ends, and the anastomosis after the stump is removed without tension. It is not advisable to separate too much, so as not to affect the blood supply of the vas deferens. Excision of the distal and proximal stump scars. 5. Introduce the stent wire into the vas deferens at one end and insert the lumen from the proximal end of the vas deferens with a 7-8 needle to the wall 1.5 cm away from the broken end and pass through the skin of the scrotum. The nylon thread is introduced into the needle cavity, the needle is withdrawn, the nylon thread is left in the lumen, the end is exposed on the outside of the skin, and the skin end is sutured to the skin with a silk thread. 6. Insert the stent wire into the lumen of the other end of the vas deferens. Insert the other end of the nylon thread into the distal vas deferens lumen 4 to 5 cm, and use it as a lumen stent. 7. Anastomotic vas deferens with 7-0 nylon thread or 5-0 silk thread to suture the vas deferens with 3 to 4 needles for end-to-end anastomosis. 8. The vas deferens is sutured with sutures to suture the tissue around the vas deferens. Generally, only 2 to 3 needles are sutured to cover the vas deferens, and then the skin incision is sutured.

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