{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:40:08Z","timestamp":1756359608144,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,6,16]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>Obstruction of the vas deferens may occur after inguinal hernia repair with mesh and lead to infertility. In cases where natural conception is desired and after obtaining test results that suggest the presence of spermatogenesis, surgical reconstruction can be attempted but may be difficult. Several approaches have been reported, including the laparoscopic mobilisation of the pelvic vas deferens, as well as mobilisation and passage of the scrotal vas deferens intra-abdominally for robot-assisted vasovasostomy. We describe a novel approach that used the surgical robot and a no-touch technique to mobilise the pelvic vas deferens and deliver it to the subinguinal region for subinguinal microsurgical vasovasostomy. This approach appeared to be feasible and safe, allows for simultaneous bilateral repair if needed, and was associated with rapid postoperative convalescence.<\/jats:p>","DOI":"10.1136\/bcr-2022-249137","type":"journal-article","created":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T03:59:56Z","timestamp":1666583996000},"page":"e249137","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Combined robotic and subinguinal microsurgical vasovasostomy for vasal obstruction after inguinal hernia repair"],"prefix":"10.1136","volume":"15","author":[{"given":"Moshe","family":"Wald","sequence":"first","affiliation":[{"name":"Urology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Department of Urology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"key":"2025082722180369000_15.6.e249137.1","doi-asserted-by":"crossref","first-page":"1842.e1","DOI":"10.1016\/j.fertnstert.2004.11.083","article-title":"Laparoscopic retrieval of retroperitoneal vas deferens in vasovasostomy for postinguinal herniorrhaphy obstructive azoospermia","volume":"83","author":"Nagler","year":"2005","journal-title":"Fertil Steril"},{"key":"2025082722180369000_15.6.e249137.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)63747-9"},{"key":"2025082722180369000_15.6.e249137.3","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1590\/S0041-87812003000600003","article-title":"Results of microsurgical anastomosis in men with seminal tract obstruction due to inguinal herniorrhaphy","volume":"58","author":"Pasqualotto","year":"2003","journal-title":"Rev Hosp Clin."},{"key":"2025082722180369000_15.6.e249137.4","doi-asserted-by":"crossref","DOI":"10.1016\/S0015-0282(01)02649-8","article-title":"Marlex mesh causing inguinal vasal obstruction: a treatable, preventable cause of obstructive azospermia","volume":"76","author":"Barme","year":"2001","journal-title":"Fertil Steril"},{"key":"2025082722180369000_15.6.e249137.5","doi-asserted-by":"crossref","DOI":"10.1097\/01.ju.0000176738.55343.75","article-title":"Pelviscrotal vasovasostomy: refining and troubleshooting","volume":"174","author":"Shaeer","year":"2005","journal-title":"J Urol"},{"key":"2025082722180369000_15.6.e249137.6","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1016\/j.juro.2013.11.107","article-title":"Intracorporeal robot-assisted microsurgical vasovasostomy for the treatment of bilateral vasal obstruction occurring following bilateral inguinal hernia repairs with mesh placement","volume":"191","author":"Trost","year":"2014","journal-title":"J Urol"},{"key":"2025082722180369000_15.6.e249137.7","doi-asserted-by":"crossref","first-page":"2521","DOI":"10.21037\/tau-21-133","article-title":"Intra-Abdominal robot-assisted vasovasostomy of obstructive azoospermia in an Asian population following multiple bilateral inguinal herniorrhaphy in childhood: a case report and literature review","volume":"10","author":"Wang","year":"2021","journal-title":"Transl Androl Urol"},{"key":"2025082722180369000_15.6.e249137.8","doi-asserted-by":"crossref","DOI":"10.1186\/1477-7819-12-122","article-title":"Robotic-Assisted versus laparoscopic colorectal surgery: a meta-analysis of four randomized controlled trials","volume":"12","author":"Liao","year":"2014","journal-title":"World J Surg Oncol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-249137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:18:12Z","timestamp":1756358292000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-249137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6]]},"references-count":8,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6,28]]},"published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1136\/bcr-2022-249137"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-249137","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,6]]}}}