Some Anatomical Points in the Operation for Undescended Testicle

Browne, Denis

doi:10.1016/s0140-6736(00)84415-3

Cited by 31 publications

(17 citation statements)

References 1 publication

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“…If it seems impossible that such a misunderstanding should exist so long I can only point to the way in which surgeons have contentedly operated for generations upon a demonstrably very inaccurate classical account of the anatomy of the whole region involved (Browne, 1933).…”

Section: Misconceptionsmentioning

confidence: 99%

Diagnosis of Undescended Testicle

Browne¹

1938

BMJ

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Section: Misconceptionsmentioning

confidence: 99%

Diagnosis of Undescended Testicle

Browne¹

1938

BMJ

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“…In 1996, Redman also described three well-defined fascial layers in the inguino-pelvic region: inner stratum, [47] the supportive connective tissue of the peritoneum; intermediate stratum, the bilaminar extraperitoneal fascia (fatty layer and membranous stroma); and outer stratum, the transversalis fascia, supporting the observations of Mark Hayes. [66] Redman also documented a 'secondary internal ring' in the plane of the preperitoneal fascia, [47] and credited Browne for the first description of a secondary internal inguinal ring, [70] who described in 1933 his clear understanding of the secondary internal inguinal ring along with a beautiful illustration. However, Browne did not name the fibrous plane of the secondary internal inguinal ring.…”

Section: Preperitoneal Fasciamentioning

confidence: 99%

“…However, Browne did not name the fibrous plane of the secondary internal inguinal ring. [70,71] In 1998, Colborn and Skandalakis documented the constant presence of a tissue-paper like membrane covering the preperitoneal fat in their innumerable cadaveric and surgical dissections, [46] and this was found fairly tough at times, although they did not capitalize on the term 'preperitoneal fascia'. Regular presence of the preperitoneal fascia was strongly supported by Memon and associates, [49,73] who emphatically cautioned against common mistake of its interpretation as the 'posterior lamina of transversalis fascia'.…”

Section: Preperitoneal Fasciamentioning

confidence: 99%

Transversalis Fascia and Preperitoneal Fascia: A Laparoscopic Study of Live Surgical Anatomy during TEPP Hernioplasty – Final Report and Literature Review

Ansari¹

2017

AIMDR

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Background: Despite excellent perspective, bright lighting and high magnification afforded by preperitoneal laparoscopy, there is still little agreement among the practicing surgeons and anatomists about transversalis and preperitoneal fascias. Methods: Study Setting -Elective Clinical; Design -Prospective; Population -Adults (≥18 years); Place -J. N. Medical College Hospital, A. M. U., Aligarh; Procedure: Laparoscopic total extraperitoneal preperitoneal (TEPP) hernioplasty; Technique: Standard 3-midline-port technique; Method: Telescopic and instrument dissection; Data collection -Intraoperative documentation and/or video recording; Data analysis -SPSS (v. 21).Results: Sixty eight TEPP hernioplasties (Unilateral TEPP 52; Bilateral 8) were successful in 60 patients. Transversalis fascia was of three types -single diaphanous layer (60%), single membranous layer associated with little/no fat (15%) and thin flimsy layer (25%). Preperitoneal fascia was observed as a definite single membranous layer in 83% of the cases, and as a double membranous layer in the remaining 17%. Internal spermatic fascia was found as an extension analog of the preperitoneal fascia in all cases in the present study, with formation of a secondary internal inguinal ring at its beginning. Easily fissile avascular plane was consistently present between preperitoneal fascia and transversalis fascia, suggesting different embryological origins. Conclusion: Preperitoneal laparoscopy of inguino-pelvic region confirmed regular presence of easily recognizable preperitoneal fascia distinct from transversalis fascia in all cases, with an easily fissile avascular preperitoneal plane in between them. Transversalis fascia was invariably unilaminar but preperitoneal fascia was at times bilaminar. Instead of transversalis fascia, preperitoneal fascia formed internal spermatic sheath with a secondary internal inguinal ring.

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“…The first comprehensive account of the surgical anatomy of testicular retention was that of Sir Denis Browne (1938), and most of the views expressed in his classic article concerning the types of undescent, their clinical and operative features, and their prognostic implications are now universally accepted. Browne classified the retained testis into the truly undescended or incompletely descended organ which halts somewhere along its normal route of descent, and the ectopic or maldescended testis which, having traversed the inguinal canal, is diverted from its course to an abnormal position.…”

Section: Anatomymentioning

confidence: 99%

“…Hunter (1762), awaiting the appropriate moment to apply a truss to the accompanying inguinal hernia, found that testicular descent occurred frequently between the ages of 2 and 10 years; it is likely, however, that the enlarging hernia was the descensive agent in these cases. Gross and Jewett (1956) believed that spontaneous descent was possible up to the age of 9 or 10 years, and Browne (1938) was of the opinion that the high retractile testis, which has a range of movement extending from the superficial inguinal pouch to the upper scrotum, took up a scrotal position at puberty.…”

Section: Embryologymentioning

confidence: 99%

The Undescended Testis

Johnston¹

1965

Archives of Disease in Childhood

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There can be few subjects in surgery where the published material contains so many divergent and even directly contradictory statements and expressions of opinion as that of the undescended testis and its management. The reasons lie in our incomplete knowledge of some of the very fundamentals of the matter. We are well informed concerning the anatomy of cryptorchidism and the effects of persisting undescent on testicular structure and function, but we know little about the late results of treatment, and much of the available information relating to the natural history of the condition and the frequency of complications is suspect since it is the outcome, not of the observation of boys and men with undescended testes, but of deductions made from the numbers of such individuals occurring in statistical surveys of the general population and of series of patients with testicular diseases. Moreover, throughout large areas of this sea of only indirectly relevant figures swim the twin red herrings, observer error and the retractile testis.

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Some Anatomical Points in the Operation for Undescended Testicle

Cited by 31 publications

References 1 publication

Diagnosis of Undescended Testicle

Diagnosis of Undescended Testicle

Transversalis Fascia and Preperitoneal Fascia: A Laparoscopic Study of Live Surgical Anatomy during TEPP Hernioplasty – Final Report and Literature Review

The Undescended Testis

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