Laparoscopy for the non-palpable testis: a review of twenty-eight patients (1988-90)

The applications of laparoscopy as a diagnostic and therapeutic tool are being continually expanded and applied to the younger patient. In this study, 28 boys with 32 non-palpable testes underwent laparoscopy as part of their management. The patients' ages ranged from 10 months to 13 years. There was one failed laparoscopy and one minor complication. Blind ending vas deferens and vessels proximal to the deep inguinal ring were noted in six patients and no viable testes were found in these boys. Five abdominal testes were noted; three underwent scrotal fixation, one was excised after failed Fowler-Stephens orchidopexy and one had a staged procedure. Twenty-one non-palpable testes were noted on laparoscopy to have the vas deferens and vessels entering the inguinal canal; of these, 12 were atrophic on inguinal exploration. The remaining nine testes were successfully fixed in the scrotum. This study concludes that laparoscopy is a safe and effective part of the management of the non-palpable testis. The advantages of laparoscopy in the localization of the testis and its potential uses in treatment are highlighted.