Extraperitoneal inguinal pelviscopy: diagnostic tool for nonpalpable testes

In patients with nonpalpable testes, intraperitoneal laparoscopy is not a direct approach to the tissues in which the gonad is likely to be located. Accordingly, the technique may be time-consuming and accompanied by complications. In 23 patients, the retropubic space was insufflated with carbon dioxide through a suprapubic puncture, and a pelviscope was advanced beyond the deep inguinal ring into the extraperitoneal pelvic cavity using the vas deferens as a guide. The nonpalpable testis was located in all patients, being deep to the inguinal ring in 17 and in the iliac fossa in 4. In the two patients with bilateral nondescent, three testes were deep to the inguinal ring, and one was lying over the psoas muscle. No complications were encountered. Extraperitoneal pelviscopy is simple, easy, and safe and provides a direct approach to the pelvic and abdominal extraperitoneal tissues.