Robotic microsurgery for male infertility

Surgical management of male infertility began with a microsurgical approach starting in 1975 when a Zeiss operating microscope was used to fashion a two-layer vasovasostomy, achieving a higher vasal patency rate and pregnancy rate than that achieved with non-microscopic repair [1, 2]. In an attempt to further promote enhanced microsurgical efficiency, ease of performance and enhanced reproducible precision, the use of robotic-assisted microsurgery is being explored. This chapter presents a detailed description of the robotic-assisted surgical techniques that we have developed for vasovasostomy, vasoepididymostomy, varicocelectomy, and testicular sperm extraction (TESE). Preliminary outcomes from our early series of approximately 300 procedures are presented.