Long-term outcome of children with patent processus vaginalis incidentally diagnosed by laparoscopy

Centeno-Wolf, N.; Mircea, L.; Sanchez, Oliver; Genin, Bernard; Lironi, Alain; Chardot, Christophe; Birraux, Jacques; Wildhaber, Barbara E.

doi:10.1016/j.jpedsurg.2015.07.001

“…Finally, laparoscopic surgery can simultaneously detect a contralateral occult hernia. Studies have shown that more than 10% of asymptomatic hernia accidentally found by laparoscopic will develop into symptomatic metachronous inguinal hernia [13,14], which require surgery again under anesthesia. A 17-year follow-up study of Taiwan also pointed out that up to 12% of contralateral occult hernia can develop into clinically inguinal hernia, about 63% of the symptoms appear within 2 years after the affected side operated, and the ratio will be as high as 91% in 5 years [15].…”

Section: Discussionmentioning

confidence: 99%

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

You

¹

,

Li

²

,

Chen

³

et al. 2020

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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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“…Finally, laparoscopic surgery can simultaneously detect a contralateral occult hernia. Studies have shown that more than 10% of asymptomatic hernia accidentally found by laparoscopic will develop into symptomatic metachronous inguinal hernia [13,14], which require surgery again under anesthesia. A 17-year follow-up study of Taiwan also pointed out that up to 12% of contralateral occult hernia can develop into clinically inguinal hernia, about 63% of the symptoms appear within 2 years after the affected side operated, and the ratio will be as high as 91% in 5…”

Section: Resultsmentioning

confidence: 99%

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

You

¹

,

Li

²

,

Li³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

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.

show abstract

“…hernia. Studies have shown that more than 10% of asymptomatic hernia accidentally found by laparoscopic will develop into symptomatic metachronous inguinal hernia [13,14], which require surgery again under anesthesia. A 17-year follow-up study of Taiwan also pointed out that up to 12% of contralateral occult hernia can develop into clinically inguinal hernia, about 63% of the symptoms appear within 2 years after the affected side operated, and the ratio will be as high as 91% in 5…”

Section: Discussionmentioning

confidence: 99%

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

You

¹

,

Li

²

,

Chen³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

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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Long-term outcome of children with patent processus vaginalis incidentally diagnosed by laparoscopy

Cited by 38 publications

References 28 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

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

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