- perform a perivasal cord block
- grasp the testicle so that the scrotal skin is held taught
- infiltrate the skin and dartos with the local
- make an incision through the skin and deepen it to expose the testicle within the tunica vaginalis (TV) sac
- excise in to the TV to expose the testicle
- place a 4-0 monocryl into the upper pole of the testis
- incise into the tunica albuginea (TA) of the testicle with the beaver blade
- remove some tubules and place them un media
- Wet prep of some sort to look for sperm present or absent and motility
- Hemostasis with bipolar as needed
- close the TA with the monocryl
- repeat above procedure as needed to find good quality sperm
- replace testicle to usual anatomic location, if necessary
- close TV and dartos with 3-0 chromic
- close dartos and skin with 4-0 monocryl
- dermabond and steris on skin
That's how the pros do it. Need one or know someone that does:
