Utility of Laparoscopic Approach of Orchiopexy for Palpable Cryptorchidism: A Systematic Review and Meta-Analysis

Abstract

Background: Traditional open orchiopexy is still a standard of treatment for palpable undescended testicles. Recently several authors reported successful results using a laparoscopic approach in the treatment of palpable cryptorchidism. The present systematic review and meta-analysis investigated the utility of laparoscopic orchiopexy for palpable cryptorchidism. Methods: Scientific databases (PubMed, Scopus, Web of Science, and EMBASE) were systematically searched for relevant articles using the following terms: (palpable cryptorchidism or palpable undescended testes) AND (laparoscopic orchiopexy or laparoscopic orchiopexy). The inclusion criteria were all children with unilateral or bilateral palpable undescended testes who underwent laparoscopic orchiopexy (LO) compared to children who underwent conventional open orchiopexy (CO). The main outcomes were the proportion of children requiring redo-orchiopexy and the incidence of postoperative complications. Secondary outcomes were duration and the cost of surgery. Results: The final meta-analysis included five studies involving 705 children; LO, n = 369 (52.3%) and CO, n = 336 (47.7%). The majority of the included patients had unilateral palpable cryptorchidism. No significant differences were found in regard to average age at the time of surgery and follow-up periods between the investigated groups. No statistically significant differences were found in regard to redo-orchiopexy rates (RR = 0.22, 95% CI 0.03–1.88, p = 0.17), early complications (RR = 0.66, 95% CI 0.21–2.08, p = 0.48) and incidence of testicular atrophy (RR = 0.36, 95% CI 0.03–3.88, p = 0.40). No significant differences in the operative duration were observed among the groups. Laparoscopy was associated with higher costs in most of the studies. Conclusion: LO is safe and effective in children with palpable cryptorchidism. The rates of redo-orchiopexy as well as an incidence of early complications and testicular atrophy rates are comparable to CO.

Minimally Invasive Surgery for Orchidopexy in Children with Cryptorchidism: Reducing the Need for an Inguinal Incision

“…Recently, a meta-analysis revealed that laparoscopic orchidopexy has a similar results as compared with conventional orchidopexy, but with the opportunity for contralateral exploration in the case of PPV. [22] In this study, the incidence of PPV in unilateral and bilateral cryptorchidism was 74.5% and 81.7%, respectively. We used a simple method of ligating the PPV using an 18-gauge intravenous indwelling needle with a suture.…”

Percutaneous Endoscopic Gastrostomy Tubes Can Be Considered Safe in Children: A Single-Center 11-Year Retrospective Analysis

“…A minimally invasive laparoscopic approach has been well described as safe and effective method in many different conditions in children [28][29][30][31][32]. Several studies showed that percutaneous gastrostomy placement has more common major complications than the laparoscopic method [33,34].…”

Open controversies on the treatment of undescended testis: An update

“…However, laparoscopy was more effective because two repeat orchiopexies were required in the open surgery group. Anand et al ( 66 ) conducted a systematic review and meta-analysis on the efficacy of laparoscopic testicular fixation in the treatment of palpable testis in 2021. The final meta-analysis included five studies involving 705 children, with 369 in the laparoscopic group and 336 in the open group.…”