No or Non Scalpel (NSV) is a new, improved and simplified approach to vasectomy. The difference between NSV and conventional method is only in approach to the vas deferens. This vital difference has resulted in lower complication rate - as seen from the results of over 10 million such vasectomies performed worldwide.

The “Combo Clamp” Advantage

Previously NSV procedure required the use of 3 instruments i.e., The Vas Fixation Clamp, Vas Dissecting Clamp and Scissors. While the Fixation Clamp and Dissecting Clamp used to work in tandem - the scissors was the odd instrument out. The focus of the surgeon used to shift from the sight of the surgery to discard the dissecting clamp and pick up the scissors. This resulted in disturbing the rhythm of the procedure.

The Instrumed “Combo Clamp” performs the dual role of dissecting and cutting. The complete procedure is now completed with 2 instruments as the need for separate scissors has been completely eliminated. The surgeons can now maintain the rhythm of the procedure saving precious time.

The NSV Procedure

“The vas deferens is fixed in the midline raphe of the scrotum by a specially designed ring forceps (Fig. 1). The amount of tissue contained in this ring is minimal amount of skin, vas deferens and very small quantity of surrounding tissues. The sharp point of the “Combo Clamp” (Fig. 2) is used to puncture the skin, directly overlying the vas contained in the ring forceps. The punctured hole is enlarged to about twice the diameter of the vas deferens; which now seen lying in the small wound. Proper performance of this step and the next step is the soul of NSV technique.

If done well, all the tissues right down up to the vas would have been separated and the bare vas will be sighted. The next step involves a delicate but firm grasping of vas deferens with the “Combo Clamp” and deliberately rotating the clamp in clockwise direction so that vas deferens is delivered out of the punctured hole.

The tissue in the loop of vas are separated gently, then the vas deferens is ligated proximately and distally with 2’0’ silk. The intervening segment of 1 cm. of vas is cut away with the lower part of the “Combo Clamp” which operates as scissors. The silk suture can also be similarly cut with “Combo Clamp”. 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 second side is similarly fixed close to the puncture hole made earlier - it is delivered through the same puncture site and ligated as before. After completion of the procedure, the wound is covered by a small dressing.”

Important: Save the tip of “Combo Clamp” Forceps from trauma. Do not use when blunt. It is recommended to discard the set after 30 cases or whenever the tip is blunt.

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