PIP: Physicians in China have developed a new technique to perform vasectomies which improves men's acceptance of vasectomy. It is called no-scalpel vasectomy. Before performing the vasectomy, the surgeon should determine whether the patient is indeed interested in permanent sterilization. The surgeon should also gather information on patient's age, marital status, and medical history and perform a physical examination. Counseling should consist of clear, simple language to diminish any fears. The surgeon must inform the patient of alternative nonpermanent means of contraception and stress that vasectomy is essentially irreversible. 2 physicians recommend external spermatic fascia injection using 2-3 ml of 2% plain lidocaine to induce vasal nerve blockage. After properly fixing the vas deferens with a ring clamp, the surgeon pierces the scrotal skin, vas sheath, and vas deferens in the midline with a curved dissecting clamp held at a 45 degree angle from horizontal. The surgeon then rotates the clamp 180 degrees to prepare the vas for cutting. The surgeon cuts out a 1 cm segment and then occludes the ends of the vas. The vas is then returned to the scrotal sac via the same puncture hole. No sutures are needed for the puncture hole. The same procedure is followed for the other vas. Hands-on training requires 10-15 procedures to develop proficiency. The no-scalpel technique takes about 40% less time than conventional techniques. The complication rate for the no-scalpel technique is 0.4 events/100 procedures compared to 3.1/100 procedures for conventional techniques. Both the ring clamp and dissecting clamp were developed in China. These instruments are provided through a company in Georgia and through the Association for Voluntary Surgical Contraception (AVSC). AVSC helps medical institutions coordinate physician training of the no-scalpel technique.