Evaluation of staged laparoscopic assisted orchidopexy for intra-abdominal testis with spermatic and gubernacular artery sparing

Document Type : Original Article

Authors

Department of General surgery, Faculty of Medicine, Beni-Suef University

10.21608/ejmr.2024.269502.1553

Abstract

Background and Objectives: The optimal approach for placing intra-abdominal undescended testes (IAT) in the scrotum remains controversial. Prioritizing testicular location and viability are key to successful orchiopexy. This single-arm clinical trial explored a novel staged laparoscopic technique for intra-abdominal undescended testis (UDT) treatment, employing gradual spermatic cord lengthening and gubernacular vessel preservation. Aim: The aim of this study is to evaluate the benefit of staged procedure for intra-abdominal testis. The first stage is laparoscopic assisted, with lengthening of the spermatic cord intra abdominally, the next stage is inguinal approach by further elongation of the spermatic cord extra abdominally. With preservation of the spermatic vessels by gradual lengthening. Methods: forty pediatric patients with 44 impalpable UDT underwent laparoscopic-assisted cord lengthening with inguinal traction (Stage 1), followed by open inguinal cord elongation and gubernacular vessel separation (Stage 2). Results: Laparoscopy confirmed 44 intra-abdominal testes: 40 pelvic (90.9%) and 3 high infrarenal (9.1%). Successful scrotal descent was achieved in 33 testes after two stages. Four testes required a third stage for descent. And seven testes were left inguinal for further follow up. The average time between stages was 3.5-6.11 months. Conclusion: Staged laparoscopic inguinal traction orchiopexy with spermatic and gubernacular artery sparing proved safe and effective for intra-abdominal UDT treatment.

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References

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Egyptian Journal of Medical Research
Volume 6, Issue 2
April 2025
Pages 257-265

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