Laparoscopic evaluation of testicular mobility as a guide to management of intra-abdominal testes.
The optimal management of intra-abdominal testes is the subject of an ongoing debate as the result of widespread use of laparoscopy since early 1990's. A simple laparoscopic technique uses cord mobility to act as a guide to cord length and therefore predict the success of a conventional orchidopexy in cases of true intra-abdominal testes. In the technique described, the testis is displaced by stretching the testes to overly the opposite internal inguinal ring. Over a 3-year period, a total of 36 boys with 38 intra-abdominal testes, confirmed laparoscopically, were prospectively assessed. The reported "stretching maneuver" was carried out in all cases. Successful conventional orchidopexy as predicted by a positive stretch maneuver was carried out in 20 testes. When the stretch maneuver failed, conventional 2-stage open operation was done in 3 patients and Fowler-Stephens orchidopexies for the remaining 13 children. A simple test determining testicular mobility assessed during laparoscopic evaluation of intra-abdominal testes provides information of significant importance upon which the correct surgical approach can be based.
Banieghbal
B
B
Division of Paediatric Surgery, Chris Hani Baragwanath Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Republic of South Africa. banieghbal@worldonline.co.za
Davies
M
M
D000293:Adolescent; D000886:Anthropometry; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009068:Movement / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013737:Testis / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*