Laparoscopic Orchiopexy for Treating Inguinal Canalicular Palpable Undescended Testis

Abstract

The laparoscopic approach to orchiopexy is a safe way to descend the inguinal canalicular palpable testis. It offers several advantages of a minimally invasive technique and yield effective results.

Laparoscopic Pediatric Inguinal Hernia Repair: No Ligation, Just Resection

“…Other researchers also report this experience with similar results in the management of the inguinal hernia during orchidopexy. 3,4 High recurrence rates of up to 26% have been described in the recent literature with using the Awl technique, or SEAL technique (subcutaneous endoscopically assisted ligation), in which a curved or straight stainless steel needle is introduced percutaneously anterolateral to the internal ring, passing a circumferential ligature, without resection of the processus vaginalis. 5,6 Some other series report very low recurrence rates of 0.73%-4.3%.…”

Palpable Undescended Testes: 15 Years of Experience and Outcome in Laparoscopic Orchiopexy

“…Another study from He and coworkers 18 reported 103 inguinal canalicular palpable UDT that were managed with laparoscopy. From 90 patients, only one complication was encountered and occurred at the beginning of the surgeon's learning curve.…”

Laparoscopy-Assisted One-Stage Trans-Scrotal Orchiopexy Applicable to All Types of Maldescended Testes

“…Our procedure involved only cutting off a portion of the PV wall, in which cremaster muscle fibers are included, along the spermatic pedicle, instead of the separation of the vas and vessels from the PV and ligation of the PV high at its neck, because the open IIR is closed from inside of the abdomen by the Endoneedle technique (Endo, et al, 2009). For delivery of the testis, a neo-ring lateral to the bladder and medial to the median umbilical ligament has been widely utilized by employing an additional scrotal trocar for intra-abdominal and high canalicular testes (Poppas, et al, 1996, He, et al, 2008. The presence of PPV is ignored in the description of operation procedures in most reports (Samadi, et al, 2003, Chang, et al, 2001, Kim, et al, 2010, Moursy, et al, 2010, and recent consensus in the literature has been to leave the ring open because of rare occurrence of postoperative inguinal hernia (Riquelme, et al, 2006, Mohta, et al, 2003, although Poppas et al included closure of the defect using a stapling device if a hernia was present (Poppas, et al, 1996).…”

“…Ziylan O, et al reported that patients requiring reorchiopexy had inadequate repair of inguinal hernia or PPV in 62.5% of cases, which was considered to be an important factor leading to failure after surgical treatment of undescended testis (Ziylan, et al, 2004). Essentially, cryptorchidism is frequently associated with PPV as He D., et al reported associated PPV in 90.3% of ipsilateral side and 15.6% of contralateral side (He, et al, 2008). In our series, 29.6% of patients had associated hernia/hydrocele, and 84.1% of patients had ipsilateral PPV and 35.1% had cPPV.…”

“…Retractile testis is defined as the testis that is usually located outside the scrotum, but can be drawn manually into the bottom of the scrotum, and has no associated PPV. It is considered not to be true undescended testis and does not require therapy (He, et al, 2008). We performed operations on 10 boys with preoperatively diagnosed retractile testis in whom the testis was not found inside the scrotum in more than 50% of occasions during parental observation.…”