Minilaparoscopic Orchiopexy for Intra-abdominal Testis：A Case Report

Abstract

Recently laparoscopic orchiopexy has been accepted as an appealing diagnostic and therapeutic procedure for clinically impalpable testes. Due to the small stature of infant patients, the 5- or 10-mm trocar is relatively invasive compared with their body size. The application of a minilaparoscope (2mm) to perform orchiopexy is thus encouraged. A 2 -yr - old boy, with left impalpable testis noted since birth, was sent to our OPD by his parents after receiving pharmacological stimulation with human chorionic gonadotropin (HCG). The result of ultrasound revealed an intra-abdominal testis located above the internal ring. Orchiopexy with minilaparoscopy was performed by a supraumbilical incision for inserting a minichiopexy with minilaparoscopy was performed by a supraumbilical incision for inserting a minitrocal (2mm), and another two 2-mm accessory working ports were placed at the midpoint between the umbilicus and anterior superior iliac spine. An intra-abdominal testis located above the internal ring was noted. Using minilaparoscopic instruments to mobilize the testis and the spermatic cord, the testis was totally freed for 10 cm with attached vas deferens. A 1.5-cm transverse incision in the inguinal skin fold was made at the external ring to extract the testis and to perform orchiopexy. The postoperative course was smooth, and the patient was discharged the next day. After a follow up of 2 mo, his condition was excellent good. It appears minilaparoscopic orchiopexy is a feasible and appealing minimally invasive surgical technique to treat an impalpable testis. In our experience, minilaparoscopy is likely to be entirely adequate for laparoscopic orchiopexy with its advantage of minimal invasiveness for infant patient.