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Background:Palpable Undescended Testis (PUT) represents a common paediatric problem in many premature and some mature infants. There are several surgical techniques to correct PUT either through combined inguinal and scrotal incision or single transverse scrotal incision. This study assessed single high transverse scrotal incision for the management of PUT as regards to feasibility, postoperative success and final cosmetic results.Materials and Methods:One hundred twenty patients were managed at the Paediatric Surgery Department of Tanta University Hospital with PUT during the period from March 2010 to March 2014. They were all operated at the age of 6-12 months. We excluded recurrent cases, and cases older than 12 months. Through high transverse scrotal incision, the layers were divided, and the canal entered through the external ring, dissecting the PUT and bringing it through the incision. Hernia sac, if present, was ligated at the neck. Creation of the dartos pouch was then made through the same incision. All infants were followed-up at 1 month, 2 months and 6 months to detect any re-ascended cases, testicular atrophy and the final cosmetic appearance.Results:A total of 140 PUTs were operated upon in 120 patients. PUT was bilateral in 20 patients, right-sided in 65 cases and left-sided in 35 cases. Thirty testes were located at the external ring; the others were located within the inguinal canal. No cases needed a redo operation, and there was no case of postoperative testicular atrophy.Conclusion:Single high transverse incision was sufficient to deal with PUT especially, in young infants (age 6 months) with no need for conversion in most cases to the traditional two incisions technique, and good long term follow-up and a better cosmetic results.

Aim: Neonatal central vascular access (CVA) represents a daily practice in neonatal intensive care unit. Low birth weight (LBW) neonates pose a challenge to anesthetists who try the landmark technique to cannulate central veins. We reported our experience of open surgical cutdown (OSC) to insert catheters through right internal jugular vein (IJV) and assessed feasibility, operative time, durability of line, and postoperative complications of this technique.Methods: A total of 660 LBW neonates needed CVA and underwent OSC of right IJV because of medical and surgical indications. We reported operative time, whether anesthesia or sedation, whether in the theater or at the bedside, difficulties, complications and duration of line, and causes of failure. Transverse neck incision was made 1 cm above the medial third of the clavicle, right IJV was identified, venotomy was performed, and catheter was inserted.Results: A total of 660 LBW neonates had CVA in right IJV, ligation of vein occurred in the first 30 cases but later venotomy was repaired. Mean operative time was 11.3 min. No injury of the right carotid artery or vagus was reported. None had postoperative pneumothorax. Overall, 542 cases had lines until they were discharged. A total of 43 cases needed redo. Thirty-five cases had line-associated infection and 40 lines were thrombosed.Conclusion: OSC of right IJV was feasible and had lower complication rates.