Our experiences of laparoscopy in the non-palpable testes

Abstract

Aim: To demonstrate the superiority of laparoscopic undescended testicular surgery for non-palpable testicles in children in diagnosis and treatment.Methods: The files of patients between the age of 6 months and 18 years who underwent laparoscopic undescended testis investigation due to non-palpable testis in our clinic, between January 2010 and September 2021, were reviewed retrospectively. Patients with palpable testicles and patients with disorders of sex development in the examination performed under general anaesthesia were excluded from the study.Results: Fifty-three patients were included in the study. The mean age of the patients is 3.2 years (min: 8 months-max 17 years). Laparoscopic intervention was performed for a total of 59 non-palpable testicles which were left-sided in 54.7% (n=29) of the patients, right-sided in 34% (n=18), and bilateral in 11.3% (n=6). Throughout these 59 testicles, cords and vessels of 31 testicles were visualized entering the inguinal canal, atrophic testes in the abdomen were detected in 7 patients, the cord and vessels had an intraabdominal blind ending (vanishing testis) in 7 patients, and 14 testicles were in the abdomen with normal aspect.Conclusion: Simultaneous laparoscopic orchiectomy is performed in case of atrophic testis in laparoscopic exploration for non-palpable testicles. It allows the ligation of vessels of testes farther than 2 cm away from the inguinal canal, and for testes that are closer than 2 cm it grants the vessels to be released under a more precise vision thereby protecting from the complications of conventional surgery.