Laparoscopic orchidopexy: the easy way to go.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
Burjonrappa
Sathyaprasad C
SC
Pediatric Surgery, NYMC, Valhalla, NY 10546, USA. sathyabc@yahoo.com
Al Hazmi
Hamdan
H
Barrieras
Diego
D
Houle
Anne-Marie
AM
Franc-Guimond
Julie
J
D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D007223:Infant; D008297:Male; D056126:Orchiopexy / Q000379:methods*; D009929:Organ Size; D013737:Testis / Q000601:surgery; D016896:Treatment Outcome; D014649:Vas Deferens / Q000601:surgery