LaparoEndoscopic Single Site Orchidopexy for Intra-Abdominal Testes in the Pediatric Population with a Multichannel Single Port and Flexible Tip Laparoscope

Noh, Paul H.; Vinson, Mohabe A; Bansal, Danesh

doi:10.1089/end.2013.0182

Cited by 10 publications

(7 citation statements)

References 12 publications

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“…All parents were extremely satisfied with the cosmetic results. Other studies have also shown similar results [ 9 , 10 ]. Wang et al illustrated that a transumbilical single-site multiport procedure resulted in a smaller scar and less pain [ 13 ].…”

Section: Discussionsupporting

confidence: 84%

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Advantages of single-site laparoscopic orchiopexy for palpable undescended testes in children: a prospective comparison study

Yang,

He,

Chen

et al. 2024

Pediatr Surg Int

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Purpose To evaluate the feasibility of single-site laparoscopic orchiopexy for palpable undescended testes in children. Methods We prospectively studied patients with undescended testes between July 2021 and June 2022. In total, 223 patients were included in our study: 105 underwent single-site laparoscopic orchiopexy and 118 underwent conventional laparoscopic orchiopexy. During single-site laparoscopic orchiopexy, 3 ports were inserted within the umbilicus. Results No differences were observed between the groups in terms of age and laterality. For unilateral undescended testes, the operating time was longer in the single site group than in the conventional group at the early stages (55.31 ± 12.04 min vs. 48.14 ± 14.39 min, P = 0.007), but it was similar to the conventional group at the later stages (48.82 ± 13.49 min vs. 48.14 ± 14.39 min, P = 0.78). Testicular ascent occurred in one patient from each group. There was no significant difference in the success rate between the single-site group and the conventional group (99.0% vs. 99.2%, P = 0.93). In the single-site group, no visible abdominal scarring was observed, while in the conventional group, there were two noticeable scars on the abdomen. Conclusion Single-site laparoscopic orchiopexy offers superior cosmetic results and comparable success rates compared to conventional laparoscopic orchiopexy for palpable undescended testes.

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Section: Discussionsupporting

confidence: 84%

“…In 2011, single-site LO was introduced in the pediatric population, offering the advantage of a concealed incision, which was well-received by parents [ 7 ]. However, existing reports are limited and primarily focus on non-palpable testes [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Advantages of single-site laparoscopic orchiopexy for palpable undescended testes in children: a prospective comparison study

Yang,

He,

Chen

et al. 2024

Pediatr Surg Int

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“…The mean operative time for LESS orchidopexy in this report was longer than in the series reported by Noh et al [ 10 ], probably because of the use of the flexible tip laparoscope, but it was shorter than the time reported by Raju et al [ 8 ], who reported a technique using standard trocars through a single umbilical incision with an intraabdominal time of 126 minutes. The time reported by de Lima et al [ 9 ] was almost the same as in our first 3 patients.…”

Section: Discussioncontrasting

confidence: 62%

“…To our knowledge, this technique has been previously used for orchidopexy in a pediatric population by only four authors. Sultan et al [ 7 ] used an R-port in a 2-year-old boy; Raju et al [ 8 ] and de Lima et al [ 9 ] used rigid instruments in an 18-month-old child and for 3 boys, respectively; and Noh et al [ 10 ] reported a series of 17 patients in which a multichannel single port and flexible tip laparoscope were used. All of these studies showed LESS orchidopexy in children to be feasible, safe, and scarless, with no intraoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Single port laparoscopic orchidopexy in children using surgical glove port and conventional rigid instruments

et al. 2015

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PurposeWe review the literature and describe our technique for laparoendoscopic single-site orchidopexy using a glove port and rigid instruments. We assessed the feasibility and outcomes of this procedure.Materials and MethodsWe retrospectively reviewed the case records of all children who had undergone laparoendoscopic single-site orchidopexy by use of a surgical glove port and conventional rigid instruments for a nonpalpable intraabdominal testis between January 2013 and September 2014.ResultsData from a total of 20 patients were collected. The patients' mean age was 18 months. All cases had a nonpalpable unilateral undescended testis. Fourteen patients (70%) had an undescended testis on the right side and six patients (30%) had an undescended testis on the left side. Seventeen patients underwent primary orchidopexy. Three patients underwent single-port laparoscopic Fowler-Stephens orchidopexy for the first and the second stage. Average operating time was 57 minutes (range, 40 to 80 minutes). No patient was lost to follow-up. At follow-up, 2 testes were found to have retracted out of the scrotum and these were successfully dealt with in a second operation. One testis was hypoplastic in the scrotal pouch. There were no signs of umbilical hernia.ConclusionsSingle-port laparoscopic orchidopexy using a glove port and rigid instruments is technically feasible and safe for various nonpalpable intraabdominal testes. However, surgical experience and long-term follow-up are needed to confirm the superiority of this technique.

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“…A variety of procedures have been described for surgical management of IAT include laparoscopic single or staged orchidopexy [11], using multiple or single ports [12], or microvascular [13] procedures. The majority of IAT in the UK are managed with two-stage Fowler-Stephens laparoscopic orchidopexy (FSLO) whereby the testicular vessels are divided.…”

Section: Discussionmentioning

confidence: 99%

Staged laparoscopic traction orchidopexy for impalpable testes: a preliminary study

2019

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Purpose Laparoscopy is the gold standard to assess for presence of an intra-abdominal testis. However, techniques for the subsequent orchidopexy vary, and include the recently described staged laparoscopic traction orchidopexy (SLTO) (Shehata in Pediatr Surg 51(2):211-215, 2016). SLTO enables elongation of the testicular vessels without division, with initial success rates reportedly superior to Fowler-Stephens. We present the first UK data following a preliminary study using SLTO. Methods 19 boys prospectively presenting with 22 intra-abdominal testes (IAT) underwent STLO in a single centre, with a median age of 2.5 years (IQR 1.4-5.2) at first stage. 3/19 (16%) boys had bilateral IAT and nine (41%) were left-sided. Pneumoperitoneum was established using 5 mm umbilical and 3 mm accessory ports in bilateral iliac fossae. The gubernaculum and lateral peritoneal attachments were divided prior to securing the intra-abdominal testis to the contralateral anterior abdominal wall with 2/0 Ti-cron™. Second-stage procedures were planned for 3-6 months later. The securing stitch was cut; an 11 mm STEP port was placed trans-scrotally to retrieve the testis and secured in a sub-dartos pouch. Outcome measures included palpable testes in the scrotum and surgical complications. Results 13/22 IAT have undergone follow-up. Twelve (92%) IAT were palpable in the scrotum following SLTO. There was one diathermy-related bladder injury necessitating laparoscopic repair, and 3/22 (13.6%) slipped sutures, requiring repeat first-stage procedures. Conclusions Staged laparoscopic traction orchidopexy is a feasible technique, which can be performed as an alternative to Fowler-Stephens procedure, with potentially better outcomes for the testis. The complications described should be preventable as the technique evolves.

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LaparoEndoscopic Single Site Orchidopexy for Intra-Abdominal Testes in the Pediatric Population with a Multichannel Single Port and Flexible Tip Laparoscope

Abstract: Our initial experience with this technique was favorable with excellent outcomes. LESS orchidopexy is facilitated with a MCSP and FTL.

Cited by 10 publications

References 12 publications

Advantages of single-site laparoscopic orchiopexy for palpable undescended testes in children: a prospective comparison study

Advantages of single-site laparoscopic orchiopexy for palpable undescended testes in children: a prospective comparison study

Single port laparoscopic orchidopexy in children using surgical glove port and conventional rigid instruments

Staged laparoscopic traction orchidopexy for impalpable testes: a preliminary study

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