Laparoscopic orchidopexy: the easy way to go

• Published in: Journal of pediatric surgery 2009-11, Vol.44 (11), p.2168-2172
• Main Authors: Burjonrappa, Sathyaprasad C, Al Hazmi, Hamdan, Barrieras, Diego, Houle, Anne-Marie, Franc-Guimond, Julie
• Format: Article
• Language: English
• Subjects: Child, Preschool; Cryptorchidism - surgery; Follow-Up Studies; Fowler-Stephens; Functional Laterality; Humans; Infant; Laparoscopic; Male; Orchidopexy; Orchiopexy - methods; Organ Size; Pediatrics; Surgery; Testis - surgery; Treatment Outcome; Vas Deferens - surgery
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2009.06.022

Abstract Background/Purpose Intraabdominal testes represent less than 10% of cryptorchid testicles, and yet, they are the most challenging to correct. In the last 15 years, the two-stage Fowler-Stephens orchidopexy has gained popularity. The traditional approach includes laparoscopic or open clipping of the testicular vessels (first stage) and open inguinal orchidopexy (second stage). We present our experience with 2-stage orchidopexy with both stages done through a laparoscopic approach. Materials and Methods Over a recent 5-year period, we reviewed patients operated for intraabdominal testis using a two-stage laparoscopic orchidopexy with a minimum of 1-year follow-up. In this study, success is defined as a nonatrophic, intrascrotal testis. Fifteen patients met the inclusion criteria, and none were lost to follow-up. Results In the 15 patients, 11 had a unilateral intraabdominal testis, and 4 had bilateral cryptorchidism, with one of the 2 testes intraabdominal. The first stage was done at a mean age of 32 months, and the average time between the two stages was 9.7 months. All procedures (31) were done on an outpatient basis. Only 2 complications occurred, one scrotal hematoma and one redo first stage because of unsuccessful clipping noted at the time of planned second stage. The success rate is 93.3% (14/15). All testicles are intrascrotal, and all but 1 have maintained preoperative volume. Conclusion Two-stage laparoscopic orchidopexy is a fairly easy surgical procedure with minimum morbidity and high short term success rate. A larger cohort of patients with long-term follow-up is needed to substantiate these findings.