Some surgeons use a micro-laser to assist in the reconnection of the vas. Early in his reversal experience, Dr. Finnerty performed some reversals using this technique. In the laser technique, several sutures are placed to approximate the ends of the vas. A laser is then used to “spot-weld” the vas together, sealing only the outer layer. The laser cannot be used to align the inner layer of the vas.
The problem with this approach is the poor alignment of the inner lumen of the vas. While this approach may have a slightly better success rate than non-microsurgical vas reversal, the poor alignment of the inner layer often results in scarring and failure. The heat from the laser also tends to damage the delicate blood vessels in the vas required for healing without scar formation. Furthermore, if an epididymal repair is required, the laser cannot be used since it cannot perform the extremely delicate repair need for such a reconstruction.
Virtually all experienced microsurgeons have abandoned the use of the laser for reversal surgery because of these factors.
