According to https://vasectomie.net/Vasectomy_AUA_guideline.pdf:
The panel does not advocate the omission of FI (fascial interposition) in performing open ended vasectomy with MC (mucosal cautery).
When performing a vasectomy procedure with thermal cautery combined with fascial interposition over the abdominal end, is it preferable to use dissolving sutures or a clip?
By preferable I mean reducing the likelihood of complications (such as post-vasectomy pain syndrome) and reducing the likelihood of recanalization of the vas deferens.
Illustration showing the use of dissolving sutures, from https://www.researchgate.net/publication/7824462_Vasectomy_surgical_techniques_in_South_and_South_East_Asia/figures?lo=1, license: CC BY 2.0:
Illustration showing the use of dissolving sutures, from https://simplevas.net/simplevas-vasectomy/:
Illustration showing the use of clips, from https://buenafeclinic.com/vasectomy/no-scalpel-no-needle/:
Illustration showing the use of clips, from https://simplevas.net/simplevas-vasectomy/:
https://thevasectomist.com.au/no-scalpel-vasectomy/ uses a 3mm titanium clip by default:
The tube has a thin slippery outer layer called fascia. The fascia is gently pulled over the stump and kept in place with a titanium clip or absorbable suture (we use a clip by default but are happy to use a suture if preferred). FI only needs to be performed up on one end. FI to the upper end is the preferred method, allowing the bottom end to be left alone (an open vasectomy).
How is the upper end blocked. A titanium clip works nicely to seal the fascia of the upper end. Suture is used on request. The 3mm clip is MRI friendly & doesn’t bleep in airports!
Same for https://buenafeclinic.com/vasectomy/no-scalpel-no-needle/:
This step involves tying the sheath or covering of the vas over one end of the cut tube with a small titanium clip or a dissolving thread (same result), to create a natural barrier between the two cut ends.open ended vasectomy hosptial in manitoba
Fascial interposition can be carried out using titanium metal clips which are left permanently in the scrotum, or with dissolvable thread. There are many different techniques used to block the vas, even among no scalpel vasectomy physicians
and same for https://simplevas.net/simplevas-vasectomy/, whereas https://www.pollockclinics.com/no-scalpel-vasectomy/our-approach/ recommends to use dissolving sutures:
Our doctors also carry out what many studies describe as a crucial step, called fascial interposition. This step involves securing a sheath of healthy tissue between the divided ends to create a physical barrier between the two cut ends.
We accomplish this using a dissolving suture so that no foreign bodies such as metal clips are left in your scrotum.