Robotic Microsurgery for Male Infertility and Chronic Orchialgia

Abstract

Since the use of the operating microscope for microsurgery in 1975, there has been a steady increase in the use of such technology in the operative management of male infertility and chronic testicular or groin pain. Added to the reports relating to greater patency rates and fertility rates of vasovasostomy performed with the operating microscope, the concepts of magnification have been successfully applied to vasoepididymostomy and varicocele ligation. More recently, microscopic spermatic cord neurolysis has demonstrated applicability to the treatment of groin and testicular discomfort. These techniques require varying degrees of microsurgical skills and an array of supporting technology, neither of which may be part of many urologist’s personal or technical armamentarium. The melding of improved visualization with magnification to an ergonomic platform that can be operated remotely has a significant application to testicular and reproductive surgery. Robotic assistance during surgical procedures has been utilized in a wide array of surgical fields with the abovementioned benefits. This chapter covers the latest developments in the robotic microsurgical platform, robotic microsurgical tools, and current evaluations of various robotic microsurgical applications for male infertility and patients with chronic testicular or groin pain.