|Year : 2002 | Volume
| Issue : 4 | Page : 194-198
One stage laparoscopic orchiopexy without division of spermatic vessels
AK Basu, J Basu
Park Children's Centre for Treatment and Research, Kolkata, India
ABSTRACT: In the past 20 months we have performed laparoscopy on 14 boys with 18 impalpable testes. Their age ranged between 1 year 3 months and 7 years. Seven boys had left empty scrotum, 3 had right empty scrotum while the other 4 had bilateral disease. At laparoscopy on 6 occasions the vasdeferens was found to enter the internal ring. Four of these 6 patients had closed internal ring and groin exploration was done in them to excise atrophied testis. On 2 occasions the vas was entering an open internal ring. One of these patients had an inguinal testis which was pexed through the groin route while the other had an atrophied small testis which was excised laparoscopically. Of the 12 testes located in the abdomen one was atrophic and at the internal ring. This was removed laparoscopically. The other 11 were either at the internal ring or at a higher level. All these 11 testes were brought down in to the scrotum by mobilization of the testicular vessels and the vaszdeferens. Two testes in the same patient were brought down through the inguinal canal while the other 9 were brought down through the anterior rectus sheath making a new opening. On 5 occasions the mobilization was difficult. All the testes were placed in the subdartos pouch. Operating time varied between 1/2 hour (diagnostic) and 2 hours. The average postoperative stay was 2 days. One child had urine leak from an injury to the urinary bladder. At follow up 3 testes were at high scrotal position while one was near the pubic crest. There was no testicular atrophy.
Park Children's Centre for Treatment and Research, Kolkata
Source of Support: None, Conflict of Interest: None