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A comparative study between two techniques of laparoscopic orchiopexy for intra-abdominal testis
Osama Abdullah Bawazir1, Abdulrahman M Maghrabi2
1Department of Surgery, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
Summary
The Shehata technique for staged laparoscopic traction orchidopexy is a feasible option for managing intra-abdominal testes, showing comparable outcomes to the Fowler-Stephens orchiopexy at 12 months. This method is particularly effective for low-lying testes.
Area of Science:
- Pediatric Surgery
- Urology
- Minimally Invasive Surgery
Background:
- Intra-abdominal testes require effective surgical management.
- Laparoscopic orchidopexy offers various techniques for repositioning testes.
- Comparing established and novel laparoscopic approaches is crucial for optimizing patient outcomes.
Purpose of the Study:
- To report the experience with staged laparoscopic traction orchiopexy (Shehata technique).
- To compare the Shehata technique with the Fowler-Stephens orchiopexy (FSLO) for intra-abdominal testes.
Main Methods:
- Retrospective cohort study (2017-2020) at two pediatric surgery departments.
- Included patients with intra-abdominal testes undergoing laparoscopic exploration (n=41).
- Compared FSLO (n=18) with Shehata laparoscopic orchidopexy (n=11), excluding vanished testes or open/vessel-intact laparoscopic procedures.
Main Results:
- FSLO had a significantly shorter first-stage operative time (34.61 ± 6.43 min) compared to Shehata (58 ± 9.39 min), P < 0.001.
- No significant difference in the second stage operative time or initial testicular position.
- Testicular descent failure occurred in 27.27% of Shehata cases; however, 12-month follow-up showed comparable testicular size, position, and consistency between groups.
Conclusions:
- Staged laparoscopic traction orchidopexy (Shehata technique) is a viable management option for intra-abdominal testes.
- The Shehata technique demonstrates feasibility, particularly for low-lying intra-abdominal testes.
- Long-term outcomes regarding testicular size, position, and consistency are comparable to FSLO.
