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Diagnostic and therapeutic laparoscopy for nonpalpable testis
M D Argos Rodriguez1, A Unda Freire, A Ruiz Orpez
1Service of Pediatric Surgery, Maternity and Children's Hospital, Málaga, c/ Arroyo de los Angeles s/n, 29011, Spain. mdargos@telecos-malaga.com
Background:
We evaluated the use of laparoscopy in the management of impalpable testis to determine what advantages it might offer over the open approach.
Methods:
Over a 5.5-year period, a total of 46 patients with 53 nonpalpable testes underwent a laparoscopic procedure at our hospital. There were 28 cases of intraabdominal testis (52.83%), 18 cases of the vas and vessels entering the internal ring (33.96%), and seven cases of intraabdominally absent testis (13.20%). We performed a laparoscopic orchiopexy for 24 testes (scrotal in 21 cases and partial to the inguinal canal in three cases) and an orchiectomy for three testes. We encountered inguinal hernia in 14 cases (26.41%).
Results:
At follow-up, all testes were the same size as at the time of operation and were well positioned in the scrotum, except for four testes that required reoperation due to partial migration at the superficial inguinal ring. The operating time was <1 h in unilateral cases and <2 h for the bilateral cases. All procedures were completed successfully without conversion or complications.
Conclusions:
Laparoscopy is the only exploratory procedure that is accurate enough to enable the diagnosis of nonpalpable testis and also allow the surgical treatment to be done in the same setting.