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Updated: Jan 30, 2026

Vessel-Sparing Microsurgical Longitudinal Intussusception Vasoepididymostomy to Treat Epididymal Obstructive Azoospermia
Published on: May 27, 2022
Single-Armed Longitudinal Intussusception Vasoepididymostomy in an Ex Vivo Rat Model With Video Demonstration
Yelena Akelina1, Jan B Lombaard2, Nicholas J Coleman1
1Simulation, Columbia University Vagelos College of Physicians and Surgeons, New York, USA.
Abstract:
Microsurgical vasoepididymostomy (VE) is a technically demanding procedure that benefits from deliberate, reproducible skills training. Practice opportunities may be limited by the cost and availability of double-armed microsutures used in traditional two-needle intussusception techniques. Single-armed longitudinal intussusception vasoepididymostomy (SA-LIVE) reduces reliance on double-armed sutures. Although SA-LIVE has been described in prior publications, still images alone may not fully capture the sequence and microsurgical nuances; a video demonstration can improve clarity for learners. We present a step-by-step SA-LIVE technique for an ex vivo rat testis training model, using readily available single-armed 10-0 and 9-0 nylon sutures. The protocol standardizes the longitudinal intussusception sequence and is paired with a video demonstration illustrating each step to aid comprehension and reproducibility. This technical report is intended as a microsurgical training resource and does not include comparative outcome data.
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