Laparoscopic orchidectomy for undescended testis in adults.
BACKGROUND
Impalpable testis is a significant diagnostic and therapeutic challenge in adults, for both radiologist and surgeons, with few reports in literature addressing this problem in adults. Laparoscopy is a reliable and definitive procedure obviating the necessity of advance investigation and subsequent inguinal exploration in adults.


OBJECTIVE
To study the utility of laparoscopy as combined diagnostic and therapeutic modality for undescended testis in adults.


METHODS
Prospective study from a single surgical unit of a large tertiary referral centre during August 2000 to January 2002.


METHODS
Nine patients of unilateral undescended testis with average age 22.7 years (range 13-31 years) underwent diagnostic laparoscopy and orchidectomy subsequent to detailed clinical, ultrasound and examination under anaesthesia (EUA) procedure. All patients were operated with one 10 mm umbilical camera port, one suprapubic port and 1 lateral port.


RESULTS
None of the patients had palpable testis or an inguinal cough impulse on clinical examination and during EUA. In only 3(33.3%) patients, the ultrasound could locate the testis situated at the deep ring. On laparoscopy all testes were identified, 4 were present at the deep ring, 3 were intra-abdominal and 2 had blind ending vas entering the deep ring. Mesh plug was inserted in the internal ring in these 2 patients, after dissecting the peritoneum. None of the patients had intra or post-operative complications and all were discharged on the next day.


CONCLUSIONS
Laparoscopy is one of the most satisfactory methods for the diagnosis and management of non-palpable testis in adult cryptorchid patients.
Desai
C S
CS
Department of Surgery, Seth G.S. Medical College and K. E. M. Hospital, Parel, Mumbai - 400 012, India.
Prabhu
R Y
RY
Supe
A N
AN
D000293:Adolescent; D000328:Adult; D003456:Cryptorchidism / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009919:Orchiectomy / Q000379:methods*; D010173:Palpation; D011446:Prospective Studies; D016896:Treatment Outcome