Is it necessary to close the peritoneum over the deep inguinal ring during laparoscopic orchidopexy?

Khairi, Ahmed; Shehata, Sameh; El-Kholi, Nour

doi:10.1016/j.jpurol.2012.01.005

Cited by 15 publications

(7 citation statements)

References 18 publications

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“…During LO procedure, most surgeons only resect the membranes around internal ring instead of ligation ( 21 , 22 ). We take it as mandatory to prevent post-operative hernia when clinical hernia is already confirmed.…”

Section: Discussionmentioning

confidence: 99%

Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Cai

et al. 2018

Front. Pediatr.

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Purpose: To assess the outcomes of a novel laparoscopic assisted transcrotal orchidopexy (LATO) combined with percutaneous extraperitoneal closure (PEC) for palpable inguinal canalicular cryptorchidism accompany with indirect inguinal hernia, and evaluate its safety and efficiency.Materials and Methods: A retrospective cohort study for single-port LATO-PEC and traditional inguinal orchidopexy (TIO) was performed between 2011 and 2014. Totally 53 children with both palpable inguinal canalicular testes and indirect inguinal hernia were included. Median patient age was 15month (range, 6 months to 4 years). Of them, 35 patients underwent LATO-PEC procedure, utilizing an umbilical trocar for laparoscope, transcrotal dissection for orchidopexy, and an inner two-hooked cannula for ligation of the patent processus at the level of the internal ring. Three of them were bilateral, 12 on the left side and 20 on the right. Eighteen patients received TIO, seven of them on the left side and 11 on the right. Patient demographics, surgical technique, complications, and clinical outcomes were reviewed. Follow-up visits were performed to reassess position and size of the testes.Results: All 56 undescended testes were delivered into the scrotum successfully. In the LATO-PEC group, nine contralateral herniorrhaphy were accomplished simultaneously. Fifteen contralateral patent processus vaginalis (PPVs) in 32 unilateral undescended testis (UDT) were newly confirmed during the laparoscopy, while 6 of them received percutaneous extra-peritoneal herniorrhaphy for visible inguinal bubble in pneumoperitoneum condition. No additional port placement or conversion to open procedure was needed. Mean operative time for unilateral and bilateral LATO-PEC in this study was (37.81 ± 5.23) min and (53.33 ± 2.98) min, respectively. In TIO group, mean operative time was (41.11 ± 8.67) min. There was no statistical difference in operative time between the two approaches for unilateral UDTs (p = 0.098). Median follow-up interval was 24 months (range, 12–84 months). No operative complications were found in either group to date.Conclusions: Singe-port LATO-PEC is a safe, effective, and cosmetic choice for inguinal canalicular cryptorchidism accompany with indirect inguinal hernia, minimizing injuries to the vas deferens and testicular vessels. Laparoscopy can provide a diagnostic and therapeutic solution of contralateral PPV.

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Section: Discussionmentioning

confidence: 99%

Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Cai

et al. 2018

Front. Pediatr.

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“…Khairi et al performed 210 laparoscopic orchiopexy and left the internal ring open, found that there were no cases of inguinal hernia, and concluded that closing the peritoneum over the area of the deep inguinal ring may not be necessary. 13 We prefer to pass a laparoscopic dissector from the port on the affected side and pass through the inguinal canal and externalize through the scrotum to guide a forceps from the scrotum (Fig. 3A-D).…”

Section: Fig 3 (A)mentioning

confidence: 99%

Laparoscopic Orchiopexy Versus Open Orchiopexy for Palpable Undescended Testis in Children: A Prospective Comparison Study

Yang

Zeng

et al. 2020

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: Can laparoscopic orchiopexy achieve a better testicular position and a higher success rate than open orchiopexy for palpable undescended testis in children? We conducted a prospective comparison study with a large volume of cases to answer this question. Methods: A total of 256 patients with palpable undescended testis who were admitted between January 1, 2017 and December 31, 2017 were included in this study. Among them, 124 patients underwent laparoscopic orchiopexy and 132 patients underwent open inguinal orchiopexy. The outcome evaluated index included final testicular position, success rate, and complications. Results: Of 256 patients, the mean age was 2.4 years; 218 patients had unilateral palpable testis, and the other 38 patients had bilateral palpable testis. There were no significant differences between laparoscopic orchiopexy group and open orchiopexy group with respect to age, side, preoperative testicular position, and testicular volume. The final testicular position in laparoscopic group was better than that in open group (lower position rate: 89.3% versus 77.9%, P = .01). There was no significant difference in success rate (laparoscopic group: 100%; and open group: 98.5%). There were 3 complications in the laparoscopic group and 6 complications in open group (P > .05). No testicular atrophy was found in either group. No testicular ascent occurred in laparoscopic group while there were 2 cases in open group, which required additional surgery for correction. Of patients who underwent surgery at the age of 3 years or older (n = 75), laparoscopic surgery was associated with markedly better testicular position than open surgery (lower position rate: 88.1% versus 69.6%, P = .03). Conclusions: Laparoscopic orchiopexy is associated with better testicular position and comparable success rate comparing to open orchiopexy for palpable undescended testis in children. This procedure could be recommended for palpable undescended testis, especially in older children.

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“…In his study of the staged treatment of LO, they found the peritoneum of the unsutured IIR in the first stage of the operation was completely closed during the second stage of the operation. Khairi et al [19].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Laparoscopic Orchiopexy and Traditional Inguinal Incision Orchiopexy for Palpable Undescended Testes in Cryptorchidism

Wang

Luo

2021

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background Laparoscopic orchidopexy (LO) has become a standard procedure for the treatment of nonpalpable undescended testes. LO for palpable undescended testes is still controversial. The aim of this study is to explore the method and effect of laparoscopic orchiopexy procedure for palpable undescended testes in children suffering from cryptorchidism.Methods A retrospective study was performed for LO and traditional inguinal incision orchidopexy(TIIO) for palpable undescended testes. Totally 220 children age ranged from 9 months to 96 months with both palpable inguinal canalicular testes were included. 170 patients received LO and 50 patients received TIIO. Patient age, operative time and clinical outcomes were reviewed. Independent t test and Fisher's exact test were performed by SPSS 25.0 software. ResultsThe mean operative time (30.77 ± 6.02 vs 44.76 ± 6.70 min), postoperative normal activity time (1.25 ± 0.43 vs 2.48 ± 0.68 day) of LO was significantly shorter than TIO group. (P < 0.05). 47 of 49 cases (95.9%) within 1-year-old were successfully achieved LO. ConclusionLO is an appropriate choice for palpable undescended testes, especially in younger children within one-year-old. The successful percentage of LO decreased with age growing.

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Is it necessary to close the peritoneum over the deep inguinal ring during laparoscopic orchidopexy?

Cited by 15 publications

References 18 publications

Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Single-Port Laparoscopic Assisted Transcrotal Orchidopexy for Palpable Inguinal Canalicular Cryptorchidism Accompany With Indirect Inguinal Hernia

Laparoscopic Orchiopexy Versus Open Orchiopexy for Palpable Undescended Testis in Children: A Prospective Comparison Study

Comparison of Laparoscopic Orchiopexy and Traditional Inguinal Incision Orchiopexy for Palpable Undescended Testes in Cryptorchidism

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