Minimally invasive versus open surgery for reversal of tubal sterilization

Abstract

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LILACS; clinical trials registries; regional databases; conference proceedings; and references for relevant published, unpublished and ongoing trials.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.