Abstract
Introduction
Diagnostic laparoscopy is the gold standard for evaluating a child with impalpable undescended testis (UDT). During the diagnostic laparoscopy, if the vas and vessels are seen coursing through the inguinal canal, the standard norm is to explore the inguinal canal via an inguinal crease incision. In this study, however, we explored the feasibility of laparoscopic inguinal exploration without any additional inguinal crease incision.
Materials and methods
The prospective study was done from 1.1.2019 to 30.6. 2019 to assess the feasibility of the laparoscopic inguinal exploration in cases of impalpable undescended testis, where testicular vessels are found to course into the inguinal canal during a diagnostic laparoscopy. The data including the descriptive characteristics, intraoperative findings, and surgical technique were collected and analysed.
Results
There were 17 cases of impalpable UDT operated in the Department of Pediatric Surgery from January 2019 to June 2019. Mean age of the patients was 8.5 years (1–16 years). Two patients had testicular vas and vessels coursing through the inguinal canal, both of which underwent laparoscopic inguinal exploration. In both of these cases, vas and vessels were found to end in testicular nubbin, at the level of the neck of the scrotum, which were excised laparoscopically, thus avoiding the open inguinal incision.
Conclusion
Laparoscopic inguinal exploration is a feasible and attractive alternative in cases of impalpable UDT where testicular vas and vessels are found to course through the inguinal ring.
Similar content being viewed by others
References
Khatwa UA, Menon PS (2000) Management of undescended testis. Indian J Pediatr 67:449–454
Sijstermans K, Hack WW, Meijer RW, van der Voort-Doedens LM (2008) The frequency of undescended testis from birth to adulthood: a review. Int J Androl. 31:1e11
Sharifiaghdas F, Beigi FM (2008) Impalpable testis: laparoscopy or inguinal canal exploration? Scand J Urol Nephrol 42:154–157
Pirgon Ö, Dündar BN (2012) Vanishing testes: a literature review. J Clin Res Pediatr Endocrinol 4:116–120
Patil KK, Green JS, Duffy PG (2005) Laparoscopy for impalpable testes. BJU Int 95:704–708
Rodriguez MD, Freire AU, Orpez AR, Lorenzo CG (2003) Diagnostic and therapeutic laparoscopy for nonpalpable testis. Surg Endosc 17:1756–1758
Schleef J, von Bismarck S, Burmucic K, Gutmann A, Mayr J (2002) Groin exploration for nonpalpable testes: laparoscopic approach. J Pediatr Surg 37:1552–1555
Woodford E, Eliezer D, Deshpande A, Kumar R (2018) Is excision of testicular nubbin necessary in vanishing testis syndrome? J Pediatr Surg 53:2495–2497
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pathak, M., Suchiang, B., Saxena, R. et al. Laparoscopic inguinal exploration for impalpable undescended testis: can we avoid the open inguinal exploration altogether?. J Ped Endosc Surg 1, 167–170 (2019). https://doi.org/10.1007/s42804-019-00031-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s42804-019-00031-y