Feasibility and safety of monopolar diathermy as an alternative to clip ligation in laparoscopic Fowler-Stephens orchiopexy

Abstract Purpose The aims of the study were to study the effect of Fowler-Stephens orchiopexy (FSO) on testicular histology and to assess the feasibility of using monopolar diathermy as an alternative to clip ligation during laparoscopic FSO. Patients and Methods The study included 20 patients with...

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Bibliographic Details
Published in:Journal of pediatric surgery 2012-10, Vol.47 (10), p.1907-1912
Main Authors: AbouZeid, Amr Abdelhamid, Moussa, Manal Hassan, Shalaby, Mohamed Sameh, Safoury, Hesham Soliman, El-naggar, Osama, Hay, Sameh Abdel
Format: Article
Language:English
Subjects:
Adolescent
Biopsy
Child
Child, Preschool
Cryptorchidism
Cryptorchidism - surgery
Diathermy - methods
Feasibility Studies
Humans
Infant
Laparoscopy
Ligation
Male
Orchiopexy - methods
Pediatrics
Prospective Studies
Surgery
Testis
Young Adult
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Summary:Abstract Purpose The aims of the study were to study the effect of Fowler-Stephens orchiopexy (FSO) on testicular histology and to assess the feasibility of using monopolar diathermy as an alternative to clip ligation during laparoscopic FSO. Patients and Methods The study included 20 patients with 20 intraabdominal testes and short vessels managed by laparoscopic-staged FSO. Biopsies were taken from intraabdominal testes during the first and second stages of the procedure for histologic comparison. The patients in the study were divided into 2 groups according to the method of dividing the testicular vessels in stage 1. The first 13 patients (group A) were managed by clip ligation of the vessels, whereas monopolar diathermy was used in the following 7 patients (group B). Results Biopsy findings at stage 2 revealed an overall reduction in both the total number of germ cells per tubule and mean diameter of seminiferous tubules, whereas there was no statistically significant difference between the results in groups A and B. Conclusion The seminiferous cells can withstand (survive) dividing the main blood supply of the testis during FSO. The monopolar diathermy can be used as an alternative to clipping during laparoscopic procedures, having the advantages of lower expenses and using smaller instruments.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2012.04.012