Laparoscopic approach for nonpalpable abdominal testis

The approach to nonpalpable testis is probably the most important indication for laparoscopy in pediatric surgery. In abdominal testis, spermatic vessels can be too short to allow for standard orchidopexy. The division of the spermatic vessels proposed by Fowler and Stephens may result, in some cases, in testicular hypotrophy or atrophy from intraoperative devascularization. In this study, we report our experience of two-stage laparoscopic orchidopexy, first proposed by Bloom. Five patients (ages 2-10 years) were treated with this technique. Laparoscopic inspection and division of spermatic vessels were successful in all patients, with no complications. Orchidopexy was performed at an average of 6 months from the first operation. During a follow-up period of from 6 to 18 months, no patient developed atrophy or hypotrophy of the testis.