V02-06 ROBOTIC-ASSISTED TESTICULAR AUTOTRANSPLANTATION

Abstract

You have accessJournal of UrologyMisc. Benign Disease & Transplant & Renovascular (V02)1 Sep 2021V02-06 ROBOTIC-ASSISTED TESTICULAR AUTOTRANSPLANTATION Brian Chao, Nabeel Shakir, Jamie Levine, and Lee Zhao Brian ChaoBrian Chao More articles by this author , Nabeel ShakirNabeel Shakir More articles by this author , Jamie LevineJamie Levine More articles by this author , and Lee ZhaoLee Zhao More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001979.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Silber and Kelly first described the successful autotransplantation of an intra-abdominal testis in 1976. Over subsequent decades, other authors have adopted the use of laparoscopy for testicular dissection and demonstrated the viability of transplanted testes based on serial postoperative exams. We present the novel incorporation of the Da Vinci surgical robot for this technique. METHODS: The procedure was performed at our institution for an 18-year-old patient with a solitary left intra-abdominal testis. Following establishment of pneumoperitoneum, the robot is docked with four trocars across the abdomen oriented towards the left lower quadrant. Testicular dissection is carried out in standard fashion, preserving the vas deferens and its associated collaterals. The gonadal and inferior epigastric vessels are then isolated and mobilized. Once adequate length is achieved, the gonadal vessels are clipped and transected, and the testicle and inferior epigastric vessels are delivered out of the body. The robotic is then undocked and exchanged for the operating microscope. Vessels are mobilized for several centimeters and cleaned of excess adventitia. Arterial and venous anastomoses are completed with interrupted and running 9-0 Nylon, respectively. Satisfactory re-anastomosis is confirmed visually and with intraoperative Doppler. Lastly, the inguinal incision is extended to allow for access to the left hemiscrotum, and the transplanted testicle is fixed inferiorly and laterally with 5-0 Prolene. All incisions are closed in the standard fashion. RESULTS: The patient is maintained on bed rest for two days and discharged on postoperative day seven in good condition. More than six months since autotransplantation, his now intra-scrotal testicle remains palpable and stable in size. Serum testosterone is similarly unchanged from preoperative measurements. CONCLUSIONS: Robotic-assisted testicular autotransplantation is a feasible and efficacious management option for the intra-abdominal testis. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e134-e135 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Brian Chao More articles by this author Nabeel Shakir More articles by this author Jamie Levine More articles by this author Lee Zhao More articles by this author Expand All Advertisement Loading ...