Impact of Laparoscopy on the Management of Transverse Testicular Ectopia

Abstract

Transverse testicular ectopia (TTE) is an uncommon condition with different clinical presentations. A significant proportion of cases are diagnosed only during surgery and it is important to define the precise anatomy and associated anomalies in every case of TTE. Laparoscopy is being increasingly adopted in the treatment of undescended testis, especially in cases where the testis is impalpable. We hereby report a child with a variant of TTE wherein laparoscopy proved enormously beneficial in diagnosis and treatment and where a routine groin exploration was likely to have yielded an incorrect diagnosis. We also review the available literature on the use of laparoscopy in the management of TTE and its impact on the ability of surgeons to diagnose and treat TTE and its associated conditions.

Transverse Testicular Ectopia: A Rare Diagnosis during Herniotomy

“…Persistent Mullerian duct syndrome with TTE has been reported in 20% to 49% of the cases [7]. Besides persistent Mullerian remnants, other associated anomalies that had been reported includes common vas deferens, seminal vesicle cyst and bilateral renal dysgenesis [5].…”

“…Although most cases of TTE are diagnosed intra-operatively during a surgery for hernia or exploration for an undescended testis, pre-operative investigations such as ultrasonography (US), magnetic resonance imaging (MRI), arteriography, venography, computed topography [8] and diagnostic laparoscopy has been described to aid in the diagnosis. A pre-operative diagnosis allows assessment of the length of the spermatic vessels and the anatomy of the two vasa deferentia before committing to a particular mode of orchiopexy [7]. Arteriography and venography are invasive and requires general anaesthesia, a factor that needs to be taken into consideration when performed on paediatric patients.…”

Rare case of transverse testicular ectopia – Case report and review of literature

“…The management of TTE remains controversial even though an algorithm has been described for its management [21] due to its varied presenting scenarios. The available options include inguinal exploration and orchidopexy, diagnostic laparoscopy and orchidopexy, diagnostic laparoscopy and trans-septal orchidopexy, diagnostic laparoscopy and trans-septal contralateral orchidopexy [22] . The laparoscopy-assisted orchidopexy was reported by Dean and Shah [23] while Balaji and Diamond first reported a case of TTE that was both diagnosed and treated by laparoscopy [24] .…”

Laparoscopic management of transverse testicular ectopia with persistent mullerian duct syndrome

“…[ 1 ] The dividedmeso-orchium and right testis was brought through right inguinal canal. Deshpande[ 10 ] described the role of laparoscopy in TTE.…”