Laparoscopic management of impalpable undescended testes: 20 years experience

被引:20
作者
Mehendale, Vinay G. [1 ]
Shenoy, Sharad N. [1 ]
Shah, Rupin S. [1 ]
Chaudhari, Namita C. [1 ]
Mehendale, Alap V. [1 ]
机构
[1] Seth VC Gandhi & MA Vora Municipal Gen Hosp, Med Surg Clin & Hosp, Bombay, Maharashtra, India
关键词
Abnormalities; cryptorchidism; laparoscopic surgical procedures; testis; FOWLER-STEPHENS ORCHIOPEXY;
D O I
10.4103/0972-9941.118822
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Laparoscopy is the best available method to manage impalpable undescended testes. We performed our first laparoscopic orchiopexy in June 1992 and found good results in consecutive cases with laparoscopic orchiopexy over last 20 years. Materials and Methods: From June 1992 to May 2012, 241 patients with 296 impalpable testes were operated upon by laparoscopic approach. One-stage laparoscopic orchiopexy was performed in 152 cases, while two-stage Fowler - Stephens laparoscopic orchiopexy was performed in 55 cases. Laparoscopic orchiectomy was required in 20, and in 21 patients testes were absent. One-sided laparoscopic orchiopexy was performed in a male pseudo hermaphrodite. Results: None of the testis atrophied after two-stage Fowler - Stephens laparoscopic orchiopexy, while in 152 cases of single-stage orchiopexies one testes atrophied. One patient developed malignant change in the testis, 6 years after orchiopexy. Conclusions: Laparoscopy is the best way to diagnose impalpable undescended testes. No other imaging investigation was required. Single-stage laparoscopic orchiopexy for low level undescended testis has very good results. For high-level undescended testis and when one-stage mobilisation is difficult, two-stage Fowler - Stephens orchiopexy has excellent results. Minimum 4 months should separate first and second stage of laparoscopic Fowler - Stephens procedure. Even when open orchiopexy is being done for intra-canalicular testes in a child, it is advisable to be ready with laparoscopy if necessary, at the same time, in case open surgery fails to mobilise the testicular vessels adequately.
引用
收藏
页码:149 / 153
页数:5
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