Step I
Consent, Time Out, Positioning, Sterile Field
At this point, the patient has undergone pre-vasectomy counseling and examination. You are ready to proceed with the procedure.
1. Obtain written informed consent, or verify that consent has been obtained previously.
2. Perform a time out, verifying the correct patient, procedure, site, and equipment.
3. Position the patient in a comfortable supine position.
4. Perform an examination to confirm normal anatomy.
5. Clip scrotal hair if necessary.
6. Using providone iodine, wash the entire scrotum, shaft of the penis, and upper thighs where the scrotum comes into contact. Put on your sterile surgical gloves. Cover the operative field with a fenestrated drape, lifting the scrotum through the fenestration.
You are now ready to administer local anesthesia, as described in the next Procedural Steps section, Step II.
Notes
Studies have indicated higher rates of infection if the patient shaves the scrotal hair at home prior to the procedure. Thus, if excess hair need be removed, it is recommended that the physician use a standard medical shaver and dry-shave the scrotum immediately prior to the procedure.
Some physicians prefer to administer anesthetic prior to creating the sterile field, an acceptable alternative.