Robotic surgery in male infertility and chronic orchialgia

The use of robotic assistance during microsurgical procedures is currently being explored in the treatment of male infertility and patients with chronic testicular pain. Whether the addition of this technology would allow a corresponding improvement in outcomes as when the operating microscope was introduced in microsurgery is yet to be seen.

The present review covers new robotic microsurgical tools and applications of the robotic platform in microsurgical procedures such as vasectomy reversal, varicocelectomy, denervation of the spermatic cord for chronic testicular pain and microsurgical vascular anastomosis. Preliminary animal studies appear to show an advantage in terms of improved operative efficiency and improved surgical outcomes. Preliminary human clinical studies appear to support these findings. The use of robotic assistance during robotic microsurgical vasovasostomy appears to decrease operative duration and significantly improve early postoperative sperm counts compared with the pure microsurgical technique.

As with any new technology, long-term prospective controlled trials are necessary to assess the true cost-benefit ratio for robotic assisted microsurgery. The preliminary findings are promising, but further evaluation is warranted.