The first vasectomies preformed without a scalpel incision were actually performed in China in the mid-1970s.  This technique became widely available in the United States.  in the late 1980s.   Rather than make an incision, a small skin puncture is made and the vas deferens is brought out through the skin of this MUCH smaller opening where it is them divided.  The NO_SCALPEL technique proved to be much more comfortable for the patient, has far fewer complications (already very low), and has a much faster recovery time.