After the vas is divided, the lower end is allowed to slide back down into the sheath, while the upper end is held outside the sheath. An absorbable suture is then used to close the empty portion of the sheath between the two ends.
* We choose to use absorbable sutures, out of preference, as we consider it allows for more flexibility in the case of bleeding from small blood vessels.
Some surgeons may use a tiny hemoclip (the size of a grain of rice), out of preference, instead of sutures. Interestingly, some patients have requested this instead of a suture, so please let us know if this is your choice, as by default absorbable sutures will be used.
Most hemoclips are made of titanium, a non-ferromagnetic metal used for many types of implanted medical devices such as dental implants, heart valves, and joint replacements. Surgeons have used hemoclips for many years to occlude bleeding blood vessels during many operations in the abdomen and chest, sometimes over 50 clips in a single procedure. Titanium will not interfere with MRI studies and the small amounts used in hemoclips and dental implants do not set off metal detector alarms.
* Removal of a small section of the vas is not necessary, as it does not influence the effectiveness of the technique.