title: Totally laparoscopic approach for failed conventional orchiopexy.
abstract: BACKGROUND
  About 0.2-10% of patients with prior orchiopexy will require reoperation for recurrent cryptorchidism. The most common approach for these patients has been an open inguinal repeat orchiopexy. The aim of this report is to show results and feasibility with the totally laparoscopic approach for failed prior open orchiopexy.
  
  
  METHODS
  Nine patients with 11 recurrent undescended testes were treated by the totally laparoscopic orchiopexy approach. We used a four-port technique, starting with laparoscopic dissection of the vas deferens and spermatic vessels as high as possible in order to get adequate length of these structures. The inguinal internal ring was opened, and the testis was dissected to finally bring it into the abdominal cavity. A transcrotal trocar was introduced all the way to the abdominal cavity to finally pull through the testis into the scrotum.
  
  
  RESULTS
  Laparoscopic orchiopexy was performed satisfactorily in all but 1 case in a mean time of 90 minutes. We did not experience any perioperative complications. In a mean follow-up of 25 months there has not been any recurrent cryptorchidism or atrophic testis.
  
  
  CONCLUSIONS
  Laparoscopy offers the advantage of achieving an extensive mobilization of spermatic vessels and a careful dissection of the vas deferens. The totally laparoscopic approach for a failed orchiopexy represents a feasible, safe, and successful procedure.
authors.affiliation: Department of Pediatric Surgery, Christus Muguerza Hospital, Monterrey, Nuevo Leon, Mexico. cima_riquelme@hotmail.com
authors.forename: Mario
authors.initials: M
authors.lastname: Riquelme
authors.forename: Arturo
authors.initials: A
authors.lastname: Aranda
authors.forename: Mario
authors.initials: M
authors.lastname: Rodarte-Shade
authors.forename: Jaime
authors.initials: J
authors.lastname: Rodriguez-Gomez
authors.forename: Jairo
authors.initials: J
authors.lastname: Torres-Riquelme
mesh_terms: D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D005240:Feasibility Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D056126:Orchiopexy; D012008:Recurrence; D012086:Reoperation; D013737:Testis / Q000601:surgery*