Feasibility and safety of monopolar diathermy as an alternative to clip ligation in laparoscopic Fowler-Stephens orchiopexy.
OBJECTIVE
The aims of the study were to study the effect of Fowler-Stephens orchiopexy (FSO) on testicular histology and to assess the feasibility of using monopolar diathermy as an alternative to clip ligation during laparoscopic FSO.


METHODS
The study included 20 patients with 20 intraabdominal testes and short vessels managed by laparoscopic-staged FSO. Biopsies were taken from intraabdominal testes during the first and second stages of the procedure for histologic comparison. The patients in the study were divided into 2 groups according to the method of dividing the testicular vessels in stage 1. The first 13 patients (group A) were managed by clip ligation of the vessels, whereas monopolar diathermy was used in the following 7 patients (group B).


RESULTS
Biopsy findings at stage 2 revealed an overall reduction in both the total number of germ cells per tubule and mean diameter of seminiferous tubules, whereas there was no statistically significant difference between the results in groups A and B.


CONCLUSIONS
The seminiferous cells can withstand (survive) dividing the main blood supply of the testis during FSO. The monopolar diathermy can be used as an alternative to clipping during laparoscopic procedures, having the advantages of lower expenses and using smaller instruments.
Pediatric Surgery Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt. amrabdelhamid@hotmail.com
Amr Abdelhamid
AA
AbouZeid
Manal Hassan
MH
Moussa
Mohamed Sameh
MS
Shalaby
Hesham Soliman
HS
Safoury
Osama
O
El-naggar
Sameh  Abdel
S
Hay
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D003972:Diathermy / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D007223:Infant; D008026:Ligation; D008297:Male; D056126:Orchiopexy / Q000379:methods*; D011446:Prospective Studies; D055815:Young Adult