Abstract
Autotransplantation presently constitutes the best option for the surgical treatment of non-palpable retained intra-abdominal testes. Silber first proposed this technique in 1978; it is not suitable in children under 3 years of age because of the small caliber of the testicular artery. In 1986 Dòmini, mindful of the problem of arterial vascularisation, carried out “refluent testicular autotransplantation” (RTAT), where a natural anastomosis between the testicular and deferential arteries is used. Venous drainage is guaranteed by performing a microsurgical anastomosis between the internal spermatic and inferior epigastric veins.
At our institution this technique has been employed since 1990, replacing staged orchidopexy. We report a 2-year experience (1990–1992) in seven children who underwent RTAT and discuss the results obtained and the technique used.
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References
Bachy B, Bawab F, Mitrofanoff P, Borde J (1987) Testicles inabaissables: abaissement en deux temps ou technique de Fowler. Chir Pediatr 28: 310–313
Corkery JJ (1975) Staged orchidopexy — a new technique. J Pediatr Surg 10: 515–518
Dòmini R, Lima M, Appignani A (1985) Autotransplantation of the testicle in paediatrics utilising microsurgical technique. Z Kinderchir 40: 351–354
Dòmini R, Lima M (1989) L'autotrapianto microvascolare “refluo” del testicolo. Rass It Chir Ped XXXI: 213–223
Fowler R, Stephens FD (1959) The role of testicular vascular anatomy in the salvage of high undescended testis. Aust N Z Surg 29: 92–106
Frey P, Bianchi A (1987) Microvascular orchidopexy. Eur J Ped 146: 551–554
Gentile C, Lima M, Romeo C, Turiaco N, Sindona P, Rapisarda A (1989) In tema di autotrapianto del testicolo: ricerche sperimentali sui tempi e sui tipi di ischemia. Atti XIV Congresso Nazionale Società Italiana di Ricerche in Chirurgia, pp 1063–1068
Hundeiker M (1971) Studies on vascularization of the testis. Fortschr Med 89: 35–42
Lee LM, Johnson HW, Mc Longhlin MG (1984) Microdissection and radiographic studies of the arterial vasculature of the human testes. J Pediatr Surg 19: 297–301
Lima M, Romeo C, Gentile C, Ruggeri G, Turiaco N, Paico E, Appignani A, Dòmini R (1989) Autotrapianto testicolare nel coniglio; nuovo modello sperimentale. Atti XIV Congresso Nazionale Società Italiana di Ricerche in Chirurgia, pp 1073–1079
Mac Mahon RA, O'Brien BMcC, Cussen JL (1976) The use of microsurgery in the treatment of the undescended testis. J Pediatr Surg 11: 521–526
Mac Mahon RA, O'Brien BMcC, et al. (1980) Results of the use of auto-transplantation of the intra-abdominal testis using microsurgical vascular anastomosis. J Pediatr Surg 15: 92–96
Pique R, Worms G (1909) Le voies anastomotiques de la circulation arterielle testiculo-epididymaire. J Anat (Paris) 45: 51–64
Rossignol G, Leandri P, Serranon JP, Caissel J (1981) Successful auto-transplantation of an intra-abdominal testis by microsurgery. Eur Urol 7: 234–235
Silber S, Kelly J (1978) Successful autotransplantation of an intra-abdominal testis to the scrotum by microvascular techniques. J Urol 115: 452–454
Silber S (1981) The intra-abdominal testis: microvascular auto-transplantation. J Urol 125: 329–333
Upton J, Schuster SR, Colodny A, Murray J (1983) Testicular auto-transplantation in children. Ann J Surg 145: 514–519
Van Kote G, Servant JM, Leyder P, Dreux H, Boujou P (1988) Auto-transplantation testiculaire chez l'enfant. Chir Ped 29: 281–285
Wacksman J, Dinner M, Handler M (1982) Results of testicular auto-transplantation using the microvascular technique: experience with 8 intra-abdominal testes. J Urol 128: 1319–1321
Waldschmidt J, Schier F (1991) Laparoscopical surgery in neonates and infants. Eur J Pediatr Surg 1: 145–150
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Noccioli, B., Pampaloni, A. Refluent testicular autotransplantation by Domini's method. Pediatr Surg Int 10, 356–358 (1995). https://doi.org/10.1007/BF00182223
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DOI: https://doi.org/10.1007/BF00182223