title: Multi-incisional transumbilical laparoscopic surgery for nonpalpable undescended testes: a report of 126 cases.
abstract: OBJECTIVE
  The aim of this study was to evaluate the feasibility of multi-incisional transumbilical laparoscopic surgery for the management of nonpalpable undescended testes.
  
  
  METHODS
  A series of 126 patients with 162 nonpalpable undescended testes underwent transumbilical laparoscopic surgery. Their mean age was 1.8 years (range, 1.1-6.5 years). Of the 126 cases, 73 were left-sided, 17 were right-sided, and 36 had bilateral cryptorchidism. Primary orchidopexy and the Fowler-Stephens procedure were used to mobilize the testes.
  
  
  RESULTS
  All the operations were successfully performed without intraoperative complications. No additional ports or any conversions to an open procedure were required. Of the 162 nonpalpable undescended testes, 21 were absent or atrophied. One-hundred thirteen testes underwent primary orchidopexy, and 28 cases underwent a Fowler-Stephens orchidopexy. Patients were followed-up for 6-15 months. Only one case of testicular retraction was observed, and all others maintained a good size and the correct position. The scars were hidden within the umbilicus.
  
  
  CONCLUSIONS
  Transumbilical laparoscopic surgery is safe and feasible for nonpalpable undescended testes, and leaves no obvious abdominal or inguinal scar.
authors.affiliation: Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
authors.forename: Jiyan
authors.initials: J
authors.lastname: Yuan
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Zhou
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Wu
authors.forename: Chengwei
authors.initials: C
authors.lastname: Chai
mesh_terms: D002648:Child; D002675:Child, Preschool; D002681:China; D002921:Cicatrix / Q000517:prevention & control; D015331:Cohort Studies; D003456:Cryptorchidism / Q000175:diagnosis / Q000601:surgery*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D061646:Operative Time; D056126:Orchiopexy / Q000379:methods*; D010149:Postoperative Pain / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery*