Laparoscopic orchiopexy of intraabdominal undescended testis associated with congenital diaphragmatic hernia

Laparoscopy is an advantageous method for the repair of intraabdominal undescended testis since both an abdominal exploration and vascular elongation can be effectively performed by laparoscopic assistance. A 3-year-old boy and a 1-year-old boy complaining of unilateral nonpalpable left testes were observed following previous congenital diaphragmatic hernia repairs on the day of birth. In these operations, a laparoscopic working sheath was inserted through a small supraumbilical incision. On each boy, a laparoscopically intraabdominal testis was found close to the left internal inguinal ring. In addition, a 10-mm trocar port was placed in the right lower abdominal quadrant and a 5-mm port was placed in the left lower quadrant. For the purpose of orchiopexy, the left testicular vessels were isolated over their full length. The left side of the testis was pulled through the inguinal ring to an inguinal canal divided by the abdominal wall, and then was retracted into the scrotum. The internal ring was thereafter closed externally by the fascia transversalis. Both patients are doing well, with no testicular atrophy or inguinal hernia for 1 and 2 years, respectively, after the above operations.