An improvement in surgical technique or a sham? Value of robotic assistance for male reproductive surgery

Fertile Battle

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Volume 110, Issue 5, Page 815


Mark Sigman, M.D.


Microsurgical approaches for male reproductive surgery have become the gold standard approach for vasectomy reversal and varicocele repair by fellowship-trained male reproductive surgeons. There is little doubt that outcomes are superior with microsurgical compared to non-microsurgical approaches (1). Indeed, because of the small size of epididymal tubules, it is not possible to perform end to side vasoepididymostomies without optical magnification. Similarly, there have been significant improvements in outcomes with the application of optical magnification to varicocele repair.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.


Go to the profile of Mary Samplaski
Mary Samplaski almost 2 years ago

While robotics has played an ever expanding role in Urology, it has not done so for Male Infertility. All available data shows excellent outcomes for these delicate operations using an operative microscope (not the robot). In addition, no superiority has yet been demonstrated for the robot approach. Finally, reproductive medicine is a cash driven field and the addition of the robot from this perspective is not to be underestimated. While we want to continually optimize our outcomes, we also need to find the balance between advancing out outcomes and just using technology because it is available.