ThP2.14 - Staged laparoscopic traction orchidopexy (SLTO) for impalpable testes

Abstract

Abstract Aim SLTO enables elongation of the testicular vessels without division by Shehata (JPS 2015). We presented first UK data in 2020 assessing SLTO. It was suggested that a single stage traction procedure may be possible in some patients. We now present follow up data including the single stage traction technique. Methods Data was collected prospectively from a single centre and grouped into 2 time periods: Group A (March 2017 to July 2019), Group B (November 2020 to December 2023). The gubernaculum was divided. If the vascular pedicle was long enough to allow the testis to reach the contralateral inguinal ring the testis was brought down to the scrotum using an 11mm STEP port and secured in a subdartos pouch with 2/0 Ti-cron. If the vascular pedicle was short, 2-stage traction was performed by securing the intra-abdominal testis to the contralateral anterior abdominal wall using a 2/0 Ti-cron stitch. 3-6 months later the testis was brought down to the scrotum as described above. A prospective database was used for data collection and analysis. Outcome measures included presence of a palpable testis in the scrotum at follow-up, ultrasound determined testicular volumes and percentage difference compared to contra-lateral testis where applicable and complications. Follow up was 6 months following the 2nd stage procedure. Results The later cohort (Group B) demonstrated a higher proportion (32%) of single stage procedures compared to Group A (0%). The success rates for both groups were high 95-100%, with a significantly reduced complication rate (9%) seen in Group B compared to Group A (33%) p=0.048.