Microsurgical reconstruction to correct male infertility, although usually performed for vasectomy reversal, also is performed to correct other types of iatrogenic, congenital, and postinflammatory obstruction. In an effort to improve success rates and facilitate performance of these complex microsurgical procedures, modifications are continually suggested. This article reviews some of these proposed modifications. The modifications can be divided into five general categories: (1) use of biomaterials/sealants, (2) laser soldering, (3) use of absorbable and nonabsorbable stents, (4) new intussusception vasoepididymostomy (VE) anastomotic techniques, and (5) use of robotics. © 2008 Elsevier Inc. All rights reserved.