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Minimally invasive versus open surgery for reversal of tubal sterilization.

BACKGROUND
Although tubal sterilization procedures are considered to be permanent, requests for reversal of the procedure (re-canalisation) are not infrequent. The reversal procedure can be done either by an open laparotomy or by minimally invasive surgery (laparoscopic or robotic approach).


OBJECTIVES
To compare the relative effectiveness and safety of reversal of tubal sterilization by open laparotomy, laparoscopy and robotically assisted endoscopy.


SEARCH METHODS
On 23 October 2012 we searched the Cochrane Menstrual Disorders and Subfertility Review Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 10, 2012); MEDLINE; EMBASE; LILACS; clinical trials registries; regional databases; conference proceedings; and references for relevant published, unpublished and ongoing trials.


SELECTION CRITERIA
Randomised trials comparing the different methods of surgical reversal of tubal sterilisation.


DATA COLLECTION AND ANALYSIS
No trials that met the selection criteria were identified.


MAIN RESULTS
No data for evaluation were obtained


AUTHORS' CONCLUSIONS
Currently there is no evidence from randomised controlled trials to recommend or refute the use of a minimally invasive surgical approach (laparoscopic or robotic) or open surgery for reversal of tubal sterilization. There is a need for well conducted and reported randomised clinical trials to generate reliable evidence to inform clinical practice.