Laparoscopic orchidopexy: current surgical opinion

ABSTRACT

With the use of diagnostic laparoscopy widely accepted in the setting of the non palpable testes, nowaday's laparoscopic orchidopexy is an efficient and logical alternative to open orchidopexy. We reviewed the efficacy of laparoscopy for diagnosing the intra abdominal testes. Also we review the efficacy of primary orchidopexy, one stage and two stages laparoscopic orchidopexy for the management of the intra abdominal testes. Prospective Study includes 20 boys with 23 impalpable testes [3 patients were bilateral]. underwent laparoscopy for a non palpable testes at urosurgical department between June 2007 and February 2009. Their age ranged between 3years and 7 years. Eight patients had primary laparoscopic orchidopaxy without division of spermatic vessels twelve patients had one stage Fowler Stephen method, and Two patients had two stages Fowler Stephen method. During diagnostic laparoscopy Bilateral abdominal testes was found in 3 patients, Left intra abdominal tests was found in 10 patients, while right intra abdominal testes was found in 7 patients With the use of laparoscopic orchidopexy twenty two testes were brought down to the scrotum sixteen testes [72.7%] brought down to the normal scrotal site, while six testes [27.2%] were placed at high scrotal position. Orchidectomy was done for one [4.3%] intra abdominal testis. Laparoscopy is extremely effective for diagnosis and treatment of patients with non palpable testes. Laparoscopic orchidopexy is the logic extension of diagnostic laparoscopy for intra abdominal testes