Laparoscopic Orchiopexy for Palpable Undescended Testes: A Five-Year Experience

2006 ◽  
Vol 16 (3) ◽  
pp. 321-324 ◽  
Author(s):  
Mario Riquelme ◽  
Arturo Aranda ◽  
Carlos Rodriguez ◽  
Humberto Villalvazo ◽  
Guillermo Alvarez
2020 ◽  
Author(s):  
Jia You ◽  
Gang Li ◽  
Shuang Li ◽  
Haitao Chen ◽  
Jun Wang

Abstract 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.


Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 677
Author(s):  
Sachit Anand ◽  
Nellai Krishnan ◽  
Zenon Pogorelić

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.


2016 ◽  
Vol 12 (7) ◽  
pp. 1-5
Author(s):  
Mamochehr Ghorbanpoor ◽  
Mohamad Amirzargar ◽  
Amir Derakhshanfar ◽  
Amin Niayesh

2020 ◽  
Author(s):  
Jia You ◽  
Gang Li ◽  
Shuang Li ◽  
Haitao Chen ◽  
Jun Wang

Abstract 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.


2019 ◽  
Author(s):  
Jia You ◽  
Gang Li ◽  
Shuang Li ◽  
Haitao Chen

Abstract Background To discuss the feasibility and superiority of laparoscopic orchiopexy in the treatment of inguinal palpable undescended Testicles. 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, 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 occult hernia, and the hernia sac is ligated 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. It could detect and treat contralateral patent processus vaginalis at the same time and avoid the occurrence of metachronous inguinal hernia.


2020 ◽  
Author(s):  
Jia You ◽  
Gang Li ◽  
Shuang Li ◽  
Haitao Chen ◽  
Jun Wang

Abstract 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.


2020 ◽  
Author(s):  
Shaodong Gu ◽  
Yingxun wang ◽  
Hong Luo

Abstract Background : Laparoscopic orchidopexy (LO) has become a standard procedure for the treatment of nonpalpable undescended testes. Nevertheless, the use of LO for palpable undescended testes still remains controversial. The aim of this study was to explore the impact of laparoscopic orchiopexy procedure on palpable undescended testes in children suffering from cryptorchidism. Methods: A retrospective study was performed for LO and traditional inguinal incision orchidopexy (TIO) carried out to treat palpable undescended testes. In total, 291 children aged 9 months to 96 months with either left or right side palpable inguinal canalicular testes were included. 170 patients received LO and 121 patients received TIO. Age, operative time and clinical outcomes of the patients were reviewed. Independent t test and Fisher’s exact test were performed by using the SPSS 25.0 software. Results: In the younger groups, the mean operative time (younger than 1 year old, 30.50±5.88 vs. 39.86±6.11 min; 1-2 years old, 34.43±6.65 vs. 40.23±8.74) and postoperative normal activity time (younger than 1 year old, 1.20±0.40 vs. 2.12±0.48 days; 1-2 years old, 1.58±0.50 vs. 2.02±0.43 days) of LO were significantly shorter than those in the TIO group ( P <0.05). The operative time of LO was significantly longer than that in the TIO group in older groups (aged>3 years old). 47 of 49 cases (95.9%) of patients aged less than 1 year old were treated by LO successfully. Among the patients aged 1-2 years, 80 of 86 cases (93.0%) successfully completed LO. Totally, 43 cases were transferred to inguinal incisions. Conclusion: LO is an appropriate choice for palpable undescended testes, especially in children younger than 2 years old. The percentage of successful LO decreased with the increasing age.


2020 ◽  
Author(s):  
Shaodong Gu ◽  
Hong Luo ◽  
Yingxun wang

Abstract Background Laparoscopic orchidopexy (LO) has become a standard procedure for the treatment of nonpalpable undescended testes. LO for palpable undescended testes is still controversial. The aim of this study is to explore the method and effect of laparoscopic orchiopexy procedure for palpable undescended testes in children suffering from cryptorchidism.Methods A retrospective study was performed for LO and traditional inguinal incision orchidopexy(TIIO) for palpable undescended testes. Totally 220 children age ranged from 9 months to 96 months with both palpable inguinal canalicular testes were included. 170 patients received LO and 50 patients received TIIO. Patient age, operative time and clinical outcomes were reviewed. Independent t test and Fisher’s exact test were performed by SPSS 25.0 software.Results The mean operative time (30.77 ± 6.02 vs 44.76 ± 6.70 min), postoperative normal activity time (1.25 ± 0.43 vs 2.48 ± 0.68 day) of LO was significantly shorter than TIO group. (P < 0.05). 47 of 49 cases (95.9%) within 1-year-old were successfully achieved LO.Conclusion LO is an appropriate choice for palpable undescended testes, especially in younger children within one-year-old. The successful percentage of LO decreased with age growing.


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