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Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
The forked flap repair for hypospadias
1Department of Burns and Plastic Surgery, The Gujarat Research and Medical Institute, Rajasthan Hospitals, Camp Road, Shahibag, Ahmedabad, India.
Summary
The Forked-Flap repair is a single-stage surgical technique for hypospadias with chordee. This method offers comparable and replicable results, with a low complication rate.
Area of Science:
- Urology
- Pediatric Surgery
- Reconstructive Surgery
Background:
- Hypospadias repair remains challenging, with persistent issues in correcting penile curvature and neourethra formation.
- Existing techniques often involve multiple stages and complications, highlighting the need for improved surgical designs.
Purpose of the Study:
- To describe a novel single-stage surgical technique, the "Forked-Flap" repair, for distal and midpenile hypospadias with chordee.
- To evaluate the efficacy and safety of this technique in a cohort of pediatric patients.
Main Methods:
- The Forked-Flap repair involves single-stage correction of hypospadias with chordee in 70 cases over 11 years.
- The technique utilizes meatal-based flaps and forked flap extensions for neourethra reconstruction, with ventral chordee excision for penile straightening.
- Waterproofing with dartos tissue and reinforcement with Nesbit's prepucial tissue transfer are incorporated.
Main Results:
- The study analyzed 70 cases of single-stage Forked-Flap hypospadias repair in children aged 3-5 years.
- The Forked-Flap technique demonstrated comparable and replicable outcomes in hypospadias repair.
Conclusions:
- The Forked-Flap repair is an effective single-stage procedure for hypospadias with chordee.
- A low complication rate was observed, with a 4% incidence of urethrocutaneous fistula and no other significant complications.
