NSV- Non Scalpel Vasectomy

No-Scalpel Vasectomy is one of the most effective contraceptive methods available for males. It is more effective than the oral pill or the injectable contraceptive. It is an improvement on the conventional vasectomy with practically no side effects or complications. This new method is now being offered to men who have completed their families, as a special project, on a voluntary basis under the Family Welfare programme.

The No-Scalpel Vasectomy project is being implemented in the country ( INDIA ) to help men adopt male sterilisation and thus promote male participation in the Family Welfare programme. Ensuring the availability of this new technique up to the peripheral level will help increase the acceptance of male sterilisation in the country. The project is being funded by the UNFPA. The total contribution by UNFPA for the project is Rs. 9.15 crores. The contribution of the Government of India will be in kind such as providing centres for training and making available the necessary infrastructure at the training sites.

Non Scalpel Vasectomy or No Scalpel Vasectomy is a simplified approach to vasectomy. The difference between this new method and the conventional method is only in approach to the vas deferens. However, this deference is vital as it has resulted in lowered complication rate- as seen from the results of over 10 million vasectomies performed all over the world. After proper counseling of the client, the following steps are undertaken to perform NSV.

1.The client is operated under local anesthesia.

2. The vas deferens is fixed in the midline raphe of the scrotum by a specially designed ring forceps. The amount of tissue contained in this ring is a minimal amount of skin, the vas deferens and a very small quantity of surrounding tissues.

3. A sharp pointed instrument, much like a specially sharpened mosquito artery sharps, is used to puncture the skin directly overlying the vas contained in the ring forceps.

4. The puncture hole is enlarged to about twice the diameter of the vas deferens; which is now seen lying in the small wound. Proper performance of this step and the next step is the heart of the no scalpel vasectomy technique. If done properly all tissues right down to the vas would have been separated and the bare vas will be sighted.

5. Next step involves a delicate but firm grasping of the vas deferens with the puncturing instrument and deliberately rotating the instrument in a clockwise direction so that the vas deferens is delivered out of the puncture hole.
6. Subsequent handling of the vas such as ligature of ends of vas and excision of a small segment of vas is identical to the conventional technique. The tied ends are pushed back into scrotum.

7. The opposite vas is manipulated so as to underlie the puncture wound and this is again trapped in the ring forceps. Through the existing wound the tissues surrounding the opposite vas are punctured, dilated and the bare vas delivered as before.

8. At the end of the procedure a tiny puncture hole results which does not require any closure.

9. The net result is a no incision, no stitch vasectomy with minimal dissection using only 3 instruments (vas fixation forceps, vas dissection forceps and a scissors) as compared to around 14 instruments in conventional vasectomy. The complications such as haematoma and sepsis have been reduced from 2% to 0.3% and from 2% to nil respectively in a large series.