A tailored surgical approach to the palpable undescended testis

Neheman, Amos; Levitt, Max; Steiner, Zvi

doi:10.1016/j.jpurol.2018.08.022

Cited by 14 publications

(10 citation statements)

References 17 publications

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“…However, there are some conspicuous defects in this surgical procedure; firstly, the conventional inguinal incision is not easy to be adequately exposed, and it is likely to damage the testicular blood supply when separating the retroperitoneal spermatic cord vessels, which increases the risk of postoperative testicular atrophy. Neheman et al [3] reported 5 cases of testicular atrophy in 134 cases of inguinal cryptorchidism by trans-inguinal orchiopexy, the rate is about 3.7%. Ein et al [4] indicated that testicular atrophy occurred in about 5% of low typical inguinal cryptorchidism, while the figure reach up to 9% in higher inguinal position when testicular fixation by inguinal open approach.…”

Section: Discussionmentioning

confidence: 99%

“…Cryptorchidism over 6 months needs to be fixed in the scrotum by surgery. Currently, laparoscopy has been widely used to diagnose and treat intra-abdominal cryptorchidism, while it is still controversial for the treatment of inguinal cryptorchidism that can touch the testis [1], the classical surgical approach is trans-inguinal orchiopexy, however, there are some flaws in this surgical procedure [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

You

Chen

et al. 2020

BMC Pediatr

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Background: Discuss the superiority of laparoscopic orchiopexy in the treatment of inguinal palpable undescended testes. Methods: Inclusion criteria: Preoperative examination and color Doppler ultrasound examination confirmed that the testes were located in the inguinal canal and could not be pulled into the scrotum, except for retractive and ectopic testes. The surgical steps were depicted as follow. The retroperitoneal wall was carved by ultrasonic scalpels, separates the spermatic vessels closed to the inferior pole of the kidney if necessary, dissects the peritoneum of vas deferens, cuts the testicular gubernaculum, and pulls back the testicle into the abdominal cavity. Besides, protect the vas deferens, and descend the testes to the scrotum and fix them without tension. Results: There were 773 patients with 869 inguinal undescended palpable testes, 218 cases on the left side, 459 cases on the right side and 96 cases with bilateral undescended testes, whose age ranged from 6 months to 8 years, with an average of 20 months. All testes were successfully operated, no converted to open surgery. The average operation time was (34.8 ± 5.4) min. There were 692 testes have an ipsilateral patent processus vaginalis (89.5%); In 677 cases of unilateral cryptorchidism, 233 cases (34.4%) have a contralateral patent processus vaginalis, and laparoscopic percutaneous extraperitoneal closure the hernia sac carry out during the surgery. There was no subcutaneous emphysema during the operation, no vomiting, no abdominal distension, no wound bleeding and obvious pain after surgery, especially wound infection is rarely. Doppler ultrasound was evaluated regularly after surgery. The patients were followed up for 6 to 18 months. All the testes were located in the scrotum without testicular retraction and atrophy. No inguinal hernia or hydrocele was found in follow-up examination.Conclusion: Laparoscopic orchiopexy manage inguinal palpable cryptorchidism is safe and effective, and there are obvious minimally invasive advantages. Furthermore, It could discover a contralateral patent processus vaginalis, and treat at the same time, which avoid the occurrence of metachronous inguinal hernia.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

You

Chen

et al. 2020

BMC Pediatr

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“…Aufgrund der fehlenden inguinalen Inzision mit einem Zugang über die gefältelte Skrotalhaut zeigen sich außerdem weniger Narben mit einem deutlich verbesserten kosmetischen Ergebnis [6]. Insgesamt ist die Lernkurve steil und kurz und es handelt sich um ein auch durch Assistenzärzte einfach durchzuführendes Operationsverfahren [7].…”

Section: Introductionunclassified

“…Entgegen der bislang in der Literatur verfügbaren Daten ergab sich jedoch eine signifikant höhere Rate an Hodenhypotrophien und -atrophien in der Gruppe der mittels inguinalem Zugang operierten Kindern. Diesen Unterschied werteten die Autoren allerdings eher als ein Zeichen der Vulnerabilität der sehr hoch inguinal gelegenen Hoden, als ein Zeichen für die Überlegenheit des einen gegenüber des anderen operativen Verfahrens [7].…”

Section: Introductionunclassified

Operative Zugangswege beim Gleithoden und tiefen Leistenhoden – skrotaler Zugang

2019

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ZusammenfassungDer Hodenhochstand ist die häufigste urogenitale Erkrankung im Kindesalter. Weiterhin gilt der inguinale Zugangsweg für die Orchidofunikolyse als operative Methode der Wahl. Eine Vielzahl von Studien konnten in den letzten zwei Jahrzehnten zeigen, dass die skrotale Orchidofunikolyse aufgrund der geringen Invasivität und einer damit verbundenen reduzierten Morbidität bei deutlich kürzerer Operationszeit und einem guten kosmetischen Ergebnis bei gleichem operativen Behandlungsergebnis eine gute Alternative beim Gleit- und tiefen Leistenhoden darstellt.

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“…However, there are some conspicuous defects in this surgical procedure; firstly, the conventional inguinal incision is not easy to be adequately exposed, and it is likely to damage the testicular blood supply when separating the retroperitoneal spermatic cord vessels, which increases the risk of postoperative testicular atrophy. Neheman et al [3] reported 5 cases of testicular atrophy in 134 cases of inguinal cryptorchidism by trans-inguinal orchiopexy, the rate is about 3.7%. Ein et al [4] indicated that testicular atrophy occurred in about 5% contralateral patent processus reach up to 33%-40% [7,9], while preoperative color Doppler ultrasound examination only discovers about 20% [11].…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

You

Li³

et al. 2020

Preprint

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Background Discuss the superiority of laparoscopic orchiopexy in the treatment of inguinal palpable undescended testes. Methods Inclusion criteria: Preoperative examination and color Doppler ultrasound examination confirmed that the testes were located in the inguinal canal and could not be pulled into the scrotum, except for retractive and ectopic testes. The surgical steps were depicted as follow. The retroperitoneal wall was carved by ultrasonic scalpels, separates the spermatic vessels closed to the inferior pole of the kidney if necessary, dissects the peritoneum of vas deferens, cuts the testicular gubernaculum, and pulls back the testicle into the abdominal cavity. Besides, protect the vas deferens, and descend the testes to the scrotum and fix them without tension. Results There were 773 patients with 869 inguinal undescended palpable testes, 218 cases on the left side, 459 cases on the right side and 96 cases with bilateral undescended testes, whose age ranged from 6 months to 8 years, with an average of 20 months. All testes were successfully operated, no converted to open surgery. The average operation time was (34.8 ± 5.4) min. There were 692 testes have an ipsilateral patent processus vaginalis (89.5%); In 677 cases of unilateral cryptorchidism, 233 cases (34.4%) have a contralateral patent processus vaginalis, and laparoscopic percutaneous extraperitoneal closure the hernia sac carry out during the surgery. There was no subcutaneous emphysema during the operation, no vomiting, no abdominal distension, no wound bleeding and obvious pain after surgery, especially wound infection is rarely. Doppler ultrasound was evaluated regularly after surgery. The patients were followed up for 6 to 18 months. All the testes were located in the scrotum without testicular retraction and atrophy. No inguinal hernia or hydrocele was found in follow-up examination. Conclusion Laparoscopic orchiopexy manage inguinal palpable cryptorchidism is safe and effective, and there are obvious minimally invasive advantages. Furthermore, It could discover a contralateral patent processus vaginalis, and treat at the same time, which avoid the occurrence of metachronous inguinal hernia.

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A tailored surgical approach to the palpable undescended testis

Cited by 14 publications

References 17 publications

Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

Operative Zugangswege beim Gleithoden und tiefen Leistenhoden – skrotaler Zugang

Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

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