Laparoscopic Orchiopexy for Treating Inguinal Canalicular Palpable Undescended Testis

Abstract

This study investigated the safety and efficacy of using the minimally invasive operation of laparoscopic orchiopexy to treat palpable inguinal canalicular undescended testes. Laparoscopic orchiopexy was performed on 90 Chinese patients (103 testes) with inguinal canalicular palpable undescended testes. Patients with testes that were nonpalpable, ectopic, retractable, or palpable but distal to the external ring were excluded. Patients in the study ranged from 8 months to 6 years old (mean age: 17 months). Of the 103 testes undergoing operation, 26.7% were on the left side of the body and 58.9% were on the right; 14.4% of the patients had bilateral undescended testes. Laparoscopic techniques were used by the same surgeon to move the spermatic vessels and transfer the testis into the scrotum. All 103 testes were successfully descended by laparoscopy. In the first 46 unilateral cases, the operation took significantly longer for the first 15 patients than the next 31, which were completed in 32.7 +/- 5.2 min. Of all 90 patients, a complication was encountered in only one, and this occurred at the beginning of the surgeon's learning curve. Of 77 unilateral undescended testes, a patent processes vaginalis was found in 90.3% of the cases on the ipsilateral side and 15.6% on the contralateral side. All of the testes maintained an adequate size and intrascrotal position with no atrophy or recurrent inguinal hernia during a follow-up of 6 to 12 months. The laparoscopic approach to orchiopexy is a safe way to descend the inguinal canalicular palpable testis. It offers several advantages of a minimally invasive technique and yield effective results.