Transscrotal approach to testicular tumors: an anatomical approach

Performing a conventional radical inguinal orchiectomy for suspected testicular cancer has three important deficiencies: 1) A benign lesion can unnecessarily and unknowingly be treated by orchiectomy. 2) Alternate routes of tumor dissemination (superficial external pudendal veins) are not clamped or destroyed before the tumor-bearing testis is brought up through the external inguinal ring. 3) The act of squeezing the testis through the external inguinal ring may be an important cause of tumor spread. Presented in this paper is a transscrotal approach that eliminates these three deficiencies. It is advocated for critical clinical evaluation.