Laparoscopy and impalpable testis--a prospective multicentric study (232 cases). GECI. Groupe d'Etude en...

The value of laparoscopy in managing the impalpable testis remains controversial. Several reports have been published on this topic but series are usually short and rather heterogeneous in their presentation, so that critical analysis is not easy to perform. Therefore, the Groupe d'Etude en Coeliochirurgie Infantile started a multicentric prospective study in May 1991 with two objectives: what are the laparoscopic findings and what are the correlations between laparoscopy and surgery? In addition, this study tried to estimate the therapeutic implications. Two hundred and one boys underwent laparoscopy accounting for two hundred and thirty-two impalpable testis. Laparoscopic findings were mainly of three types: intra-abdominal testis (36%), abdominal blind ending cord structures (14%) and cord structures entering the deep inguinal ring (49%); rarely, there was absence of testis and cord structures (1%). Crossed testicular ectopia was not found in this series. One hundred and eighty-seven impalpable testis were operated on to control laparoscopic findings and correlations laparoscopy-surgery were excellent provided that laparoscopic exploration could be entirely performed in good conditions. Moreover, it could be evaluated that forty-seven per cent of impalpable testes could take advantage of laparoscopy.