Complications of staged laparoscopic traction-orchiopexy for intra abdominal testis.

Abstract

Aim: To assess the complications of first-stage laparoscopic traction and early complications of second-stage orchiopexyfor intra-abdominal testis.Patients and Methods: A total of 78 boys were included in this study in the period from (February 2019 to April 2021)with age ranged from 6 months to 10 years; Doppler ultrasound (US) was done for ipsilateral and contralateral testis.First-stage traction was done and the testis was fixed to the anterior abdominal wall about 1 inch above and medial to the contralateral anterior superior iliac spine. Three months later second-stage laparoscopic orchiopexy was done.Results: Total 78 cryptoid boys, Doppler ultrasound revealed (27 testes were detected, 21 were extra abdominal atrophic,and 32 testes were absent), but first-stage laparoscopic exploration revealed 34 testes were present in 32 boys with 2 cases bilateral undescended testis. In 46 boys, testes were absent (25 boys had blind-ended vas and vessels, and 21 boys had extra abdominal atrophic testis). Failed traction was detected in 5 (14.7%) cases due to slippage of the stitch. Retraction was done for 3 (9%) cases only; in the other 2 cases the testicular artery was long enough for doing the orchiopexy without re-traction. 12 weeks later, second-stage orchiopexy was done with testicular fixation in the sub-dartous pouch. Testicular ascent was detected in 3 (9%) cases. Testicular atrophy was not detected in this study.Conclusion: Staged laparoscopic traction orchiopexy for intra-abdominal testes (Shehata technique) is safe and easytechnique with minimal complications and good results. This technique is a good alternative for Stephen- Fowler stagedorchiopexy that carries higher incidence of testicular atrophy.