No-scalpel vasectomy, or NSV or keyhole vasectomy, is a surgical method of sterilization that involves puncturing the skin of the scrotum to access the vas deferens, a tube that carries spermatozoa, or sperm, from the testes to the penis. The surgeon performing the procedure blocks the flow of sperm through the vas deferens, sterilizing the patient. NSV is a less invasive procedure, as it does not use a scalpel to make a deep cut on sensitive scrotal tissue. Typically, urologists perform NSV with the purpose of rendering the patient sterile while not altering other functions of the testes, scrotum, and penis. Li Shunqiang developed the technique in China in 1974 as a less invasive method of vasectomy for male patients. Li’s development of NSV provided an alternative method to vasectomies that rely on making incisions into the scrotum with a blade. NSV gained wide use as a sterilization technique, providing a path for males to take greater responsibility for contraception and family planning.
Harry Clay Sharp was a surgeon who performed one of the first recorded vasectomies with the purpose of sterilizing a patient. Sterilization is the practice that makes a person unable to reproduce, and vasectomy accomplishes that by severing the vasa deferentia, the sperm-carrying tubes in the male reproductive system. Historically, sterilization procedures have varied in techniques, goals, and risks, but Sharp’s method of vasectomy allowed restriction of a patient’s reproductive functions without significantly affecting other bodily functions. Historians have associated Sharp’s use of the procedure, primarily on prison inmates, with eugenics, a movement with the goal of bettering humans via selective reproductive practices. With vasectomy, Sharp was able to sterilize people whom he did not deem fit to reproduce. Beyond simply pushing forward a new surgical method of sterilization, Sharp’s political advocacy led to the use of his technique as a method of eugenicist control over human reproduction, especially in Indiana.
In 1998, urologists Marc Goldstein, Philip Shihua Li, and Gerald J. Matthews published “Microsurgical Vasovasostomy: The Microdot Technique of Precision Suture Placement,” hereafter “The Microdot Technique,” in The Journal of Urology. The authors describe a novel technique for reversing a vasectomy, which blocks a patient’s flow of sperm, preventing the patient from fertilizing a partner’s egg. The technique relies on the placement of microscopic dots to guide the placement of the stitches that reconnect the vasa deferentia, which is a part of the male reproductive system. The authors, working from the Center for Male Reproduction and Microsurgery at Weill Cornell Medicine in New York City, New York, published the article to instruct surgeons on how to properly employ the surgical technique and provide data to indicate the technique’s effectiveness. Through the publication of “The Microdot Technique,” Goldstein, Li, and Matthews provide guidelines to conduct a more successful and accurate method of a vasovasostomy.