title: Use of laparoscopy as the initial surgical approach of impalpable testes: 10-year experience.
abstract: OBJECTIVE
  To review the experience in the management of impalpable testes using laparoscopy as the initial approach and the need for inguinal exploration.
  
  
  METHODS
  From January 2004 to June 2014, 339 patients with undescended testes underwent operation in our institute. Fifty patients (15%) had impalpable testes. All children with impalpable testes underwent initial laparoscopy. A retrospective review was conducted on this group of patients and the outcome was analyzed.
  
  
  RESULTS
  Forty children had unilateral impalpable testis. Ten children had bilateral impalpable testes. Thirty-one children (78%) in the unilateral group underwent subsequent inguinal exploration while 4 children (40%) in the bilateral group underwent inguinal exploration (P < 0.05). Orchidopexy was performed in 16 children (40%) in the unilateral group and 9 children (90%) in the bilateral group (P < 0.05). Regarding the 24 children with unilateral impalpable testis and underwent orchidectomy for testicular nubbin (n = 19) or atrophic testes (n = 2) or has vanishing testes (n = 3); contralateral testicular hypertrophy was noticed in 10 (41%). No intra-operative complication was encountered. Two children after staged Fowler-Stephens procedure and 1 child after inguinal orchidopexy had atrophic testes.
  
  
  CONCLUSIONS
  The use of laparoscopy in children with impalpable testes is a safe procedure and can guide the need for subsequent inguinal exploration. Children with unilateral impalpable testis were associated with an increased need for inguinal exploration after laparoscopy. Orchidopexies could be performed successfully in 90% of children with bilateral impalpable testes.
authors.affiliation: Kin Wai Edwin Chan, Kim Hung Lee, Hei Yi Vicky Wong, Siu Yan Bess Tsui, Yuen Shan Wong, Kit Yi Kristine Pang, Jennifer Wai Cheung Mou, Yuk Him Tam, Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, the Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Kin Wai Edwin
authors.initials: KW
authors.lastname: Chan
authors.affiliation: Kin Wai Edwin Chan, Kim Hung Lee, Hei Yi Vicky Wong, Siu Yan Bess Tsui, Yuen Shan Wong, Kit Yi Kristine Pang, Jennifer Wai Cheung Mou, Yuk Him Tam, Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, the Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Kim Hung
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Kin Wai Edwin Chan, Kim Hung Lee, Hei Yi Vicky Wong, Siu Yan Bess Tsui, Yuen Shan Wong, Kit Yi Kristine Pang, Jennifer Wai Cheung Mou, Yuk Him Tam, Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, the Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Hei Yi Vicky
authors.initials: HY
authors.lastname: Wong
authors.affiliation: Kin Wai Edwin Chan, Kim Hung Lee, Hei Yi Vicky Wong, Siu Yan Bess Tsui, Yuen Shan Wong, Kit Yi Kristine Pang, Jennifer Wai Cheung Mou, Yuk Him Tam, Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, the Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Siu Yan Bess
authors.initials: SY
authors.lastname: Tsui
authors.affiliation: Kin Wai Edwin Chan, Kim Hung Lee, Hei Yi Vicky Wong, Siu Yan Bess Tsui, Yuen Shan Wong, Kit Yi Kristine Pang, Jennifer Wai Cheung Mou, Yuk Him Tam, Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, the Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Yuen Shan
authors.initials: YS
authors.lastname: Wong
authors.affiliation: Kin Wai Edwin Chan, Kim Hung Lee, Hei Yi Vicky Wong, Siu Yan Bess Tsui, Yuen Shan Wong, Kit Yi Kristine Pang, Jennifer Wai Cheung Mou, Yuk Him Tam, Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, the Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Kit Yi Kristine
authors.initials: KY
authors.lastname: Pang
authors.affiliation: Kin Wai Edwin Chan, Kim Hung Lee, Hei Yi Vicky Wong, Siu Yan Bess Tsui, Yuen Shan Wong, Kit Yi Kristine Pang, Jennifer Wai Cheung Mou, Yuk Him Tam, Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, the Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Jennifer Wai Cheung
authors.initials: JW
authors.lastname: Mou
authors.affiliation: Kin Wai Edwin Chan, Kim Hung Lee, Hei Yi Vicky Wong, Siu Yan Bess Tsui, Yuen Shan Wong, Kit Yi Kristine Pang, Jennifer Wai Cheung Mou, Yuk Him Tam, Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, the Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Yuk Him
authors.initials: YH
authors.lastname: Tam
keywords: Impalpable; Inguinal; Laparoscopy; Testis