[Laparoscopic examination of non-palpable testis]

Approximately 20% of undescended testes are impalpable. They can be located intraabdominally, in the inguinal canal, in ectopic position, or they can be missing. Traditionally, surgical groin exploration has been carried out in such cases, sometimes followed by laparotomy if no testis or spermatic cord could be found in the groin. This approach often involves unnecessary and sometimes too extensive surgery. Laparoscopy facilitates the identification of the testicle or proves the lack of it in a less invasive way.

From 1986 to 1999, 77 boys aged one year five months to 13 years 7 months underwent laparoscopy for unilateral or bilateral nonpalpable testis in our department.

In 72 boys (94%), the findings were conclusive in the form of intraabdominal testis in 26, an intact intraabdominal spermatic cord entering the deep inguinal ring in 27, and a missing testis in 19 boys.

Laparoscopy identified the boys who did not require further surgery because the testis was missing, Furthermore, when a testis was found, laparoscopy was helpful in choosing the most appropriate method of orchiopexy. It is concluded that at present, laparoscopy is the preferred method of investigation in boys older than one year of age with nonpalpable testis.