title: Palpable Undescended Testes: 15 Years of Experience and Outcome in Laparoscopic Orchiopexy.
abstract: OBJECTIVE
  Most of the current literature concerning laparoscopy in patients with cryptorchidism reports on those with nonpalpable testes. The purpose of this study is to share our experience and outcome in laparoscopic orchiopexy on patients with palpable undescended testes.
  
  
  METHODS
  From January 1999 to July 2014, 240 cryptorchid testes were treated of which 192 (155 patients) were palpable and were operated on by laparoscopy. Before starting, the bladder is emptied with a Foley catheter. Four trocars are used: One 5 mm for the lens (45 degree), one 10 mm (transscrotal), and two 3 mm placed at the subcostal midclavicular line for the instruments. We localize the deep inguinal ring and open the peritoneum. The spermatic vessels and vas deferens are dissected in a cephalic direction. The epigastric vessels are dissected and sectioned to facilitate the localization of the testicle inside the canal. Once found, the testis is dissected and taken into the abdominal cavity where the gubernaculum testis is cut. A 10-mm trocar is introduced through the scrotal sac into the peritoneal cavity. The testicle is grabbed and pulled down to the scrotum where it will be fixed with a 5-0 polypropylene suture in the usual manner.
  
  
  RESULTS
  Of 192 cryptorchid palpable testes treated with laparoscopy, only one procedure was converted to conventional open orchiopexy because of an ectopic testicle (above the aponeurosis of the oblique muscle). The rest of the testicles could be moved down to the scrotal sac. Our follow-up ranges from 6 months to 15 years, and we have not found atrophy in any of the testicles. To date, only two (0.4%) testicles have reascended.
  
  
  CONCLUSIONS
  Laparoscopy is a great and safe option for patients with palpable undescended testes, regardless of its position in the inguinal canal.
authors.affiliation: 1 Department of Pediatric Surgery, Christus Muguerza Hospital , Monterrey, Mexico .
authors.forename: Mario
authors.initials: M
authors.lastname: Riquelme
authors.affiliation: 2 General Practice , Monterrey, Mexico .
authors.forename: Rodolfo A
authors.initials: RA
authors.lastname: Elizondo
authors.affiliation: 3 Department of Pediatric Surgery, Wright State University , Dayton, Ohio.
authors.forename: Arturo
authors.initials: A
authors.lastname: Aranda
mesh_terms: D034841:Abdominal Cavity / Q000601:surgery*; D000009:Abdominal Muscles; D057785:Catheters; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery*; D006801:Humans; D007223:Infant; D007264:Inguinal Canal / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D061646:Operative Time; D056126:Orchiopexy / Q000379:methods*; D010529:Peritoneal Cavity / Q000601:surgery*; D010537:Peritoneum / Q000601:surgery*; D013514:Surgical Procedures, Operative; D013537:Sutures; D013737:Testis / Q000473:pathology; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery; D014649:Vas Deferens / Q000601:surgery