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Does the internal inguinal ring need closure during laparoscopic orchiopexy with Prentiss manoeuvre?
Sarath Kumar Narayanan1, Jagadeesh N Puthenvariath2, Prathap Somnath2
1Department of Pediatric Surgery, Institute of Maternal and Child Health, Government Medical College, Kozhikode, Kerala, 673008, India. drsharat77@gmail.com.
International Urology and Nephrology
|October 23, 2016
Summary
Leaving the deep inguinal ring (DIR) open during laparoscopic orchiopexy (LO) for undescended testes is safe. This approach for non-palpable testes (NPT) did not result in post-operative hernias.
Area of Science:
- Pediatric Surgery
- Urology
Background:
- Undescended testis affects 3% of male infants, necessitating surgical intervention.
- Laparoscopic orchiopexy (LO) is a common treatment for non-palpable testes (NPT).
Purpose of the Study:
- To evaluate the outcomes of leaving the deep inguinal ring (DIR) open during LO for NPT.
- To assess the incidence of post-operative hernia formation after this surgical approach.
Main Methods:
- A cohort of 63 testicular units with NPT were managed using laparoscopy between 2012 and 2014.
- For intra-abdominal testes (42 units), the DIR was intentionally left open after testicular mobilization into the scrotum (Prentiss maneuver).
- Patients were followed up to monitor for hernia development and other complications.
Main Results:
- The study included patients aged 10 months to 11 years (mean 3.7 years).
- Over a mean follow-up of 34.4 months, no hernias or hydroceles were observed.
- No other post-operative complications were reported.
Conclusions:
- Omitting peritoneal closure over the DIR during LO with the Prentiss maneuver is a viable option.
- This technique can reduce operative time and effort without increasing the risk of hernia formation.
