Laparoscopic Orchiopexy for Pediatric Ectopic Testis

Ectopic testis (ET), testicular descent outside the normal pathway, is a rare condition with variants such as perineal ET (PET), femoral ET (FET), and transverse testicular ectopia (TTE). Most studies on ET have reported open surgical techniques, whereas laparoscopic evidence remains limited. This retrospective single-center study evaluated the feasibility and safety of laparoscopic orchiopexy for pediatric ET.

We retrospectively reviewed 2306 pediatric patients aged <10 years who underwent laparoscopic orchiopexy for abnormal testicular descent between January 2016 and December 2024 at Damsoyu Hospital, Seoul, Republic of Korea. Among them, 11 were diagnosed with ET and classified as PET, FET, or TTE based on the location of the testis. PET and FET showed the testis elevated into the abdominal cavity and repositioned through the inguinal canal. On TTE, both testes were separated intraabdominally and fixed bilaterally.

The cohort included 3 PET, 3 FET, and 5 TTE patients, with a mean age of 19.8 months (6-86) and a mean operating time of 38.4 minutes (31-1). The average testicular size increased from 12 mm preoperatively to 13 mm on the 3-month postoperative follow-up ultrasonography. No intraoperative or postoperative complications occurred in the ET group, and conversion to open surgery was not required. During the mean follow-up of 55.7 months, no testicular atrophy or reoperation was observed.

Although the cohort size is small due to the rarity of ET, these findings demonstrate that laparoscopic orchiopexy is feasible and safe for pediatric ET.