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[Laparoscopy in the diagnosis, classification and therapy of nonpalpable undescended testes]
Objective:
The use of laparoscopy in children for the diagnosis, classification and treatment of non-palpable testes. High forms of undescended testes in an abdominal or high inguinal position are a diagnostic and therapeutic problem in paediatric surgery.
Method:
The authors evaluate retrospectively the laparoscopic approach used in 68 boys for the diagnosis, classification and treatment of 79 undescended testes. The mean age of the operated boys was 4.58 years. In 22 (27.9%) agenesis or atrophy of the testis was found (Type I). Thirty-two (40.5%) testes in an abdominal position (Type II) were mobilized laparoscopically, moved to the groin and the operation was completed by open orchidopexy. In 25 cases (31.6%) the laparoscopic method described by Fowler-Stephens was used treatment was completed by orchidopexy in the second stage (Type III and IV).
Results:
No serious complications were recorded during or after operation. In two instances (2.5%) after the two-stage Fowler-Stephens operation atrophy of the testis developed.
Conclusion:
Miniinvasive laparoscopy is considered at present the standard method for the localization and treatment of non-palpable testes.