The high intra-abdominal testis: technique and long-term success of laparoscopic testicular autotransplantation.

Abstract

Treatment of the high intra-abdominal testis is often a challenging problem. We present our technique of and results with laparoscopically assisted testicular autotransplantation (LATA) for treatment of the high intra-abdominal testis. We reviewed the medical records of 15 patients with a high intra-abdominal testis who underwent procedures between 1993 and 1999 in which intra-abdominal dissection and testicular mobilization was performed laparoscopically. The LATA technique is described. The 15 patients underwent 17 LATA procedures. Age at surgery ranged from 6 months to 13 years (mean 3.6 years; median 2.5 years). Two of these patients had undergone failed contralateral orchidopexy for an intra-abdominal testis, and two patients underwent metachronous bilateral procedures. The laparoscopic dissection and microvascular anastomoses were successful in all patients. There were no postoperative complications. The involved testis remained viable with adequate growth in 15 of 17 procedures (88%) during a median 42-month (range 7-70 months) follow-up. Successful procedures included those in the two patients with contralateral atrophic testes and the two who underwent bilateral procedures. The LATA demonstrated a good long-term surgical outcome and may be the technique of choice in patients with bilateral intra-abdominal testes or patients who have contralateral testis atrophy following unsuccessful orchidopexy.