Use of Laparoscopy for Impalpable Testis

Abstract

Laparoscopic intervention was successfully performed in twelve patients between 1.5 and 11.5 years of age, who had fourteen impalpable testes. Six of the 14 testes (43%) were found to be intraabdominally located. Simple orchiopexy was performed in four of them, and laparoscopic orchiectomy was do,ie smoothly in the other two due to severely hypo plastic changes of the testes and the ages of the patients. Two cases (14%) were found to have intra-abdominal vanishing testis with blind ends of vas deferens and obliterated spermatic vessels observed separately proximal to the internal inguinal ring. Vas deferens and spermatic vessels were noted to converge at the internal ring with patent processus vaginalis in five cases (six testes); inguinal exploration showed 5 testes of varying degrees of hypoplastic changes and one inguinal vanishing testis. Laparoscopic intervention is an important tool in the cryptorchid patients with impalpable testes because it can not only provide accurate diagnosis, well planning of the incisional site and minimal invasiveness, but also avoid unnecessary surgical exploration in the cases of intra-abdominal vanish testis.