Anatomical Laparoscopic Orchiopexy and Hybrid Transscrotal Orchiopexy for High Inguinal Undescended Testis: A Novel and Interfascial Technique

作者：Weiguang Zhao, Peng Sun, Jinjin Xie, Junjie Sun, Wei Zhou, Zhilin Yang, Yibin Fan, Jianchun Yin, Qitao Xu, Yingtian Zhang, Guanglun Zhou, Junhai Jiang, Shoulin Li · 发表于：Journal of Endourology · 年份：2022 · DOI：10.1089/end.2021.0744 · 被引用次数：2 · 研究领域：Testicular diseases and treatments、Sexual Differentiation and Disorders、Hernia repair and management

Background: In traditional laparoscopic orchiopexy for inguinal undescended testis (UDT) surgery, the testicles are pulled back into the abdominal cavity by grasping and cephalad retracting the testicle and the cord. If this fails, a subsequent open inguinal incision is made to complete orchiopexy. To improve the orchiolysis and avoid extra open inguinal incision, we describe our early experience with and illustrate the surgical procedure of a novel anatomical laparoscopic orchiopexy (ALO) and hybrid transscrotal orchiopexy as required in high palpable UDT. Methods: From March 2018 to April 2020, ALO was performed in 140 consecutive patients (158 testes) with high inguinal UDT. After blunt and bloodless dissection of the inter-tunica vaginalis-cremasteric fascia plane, tunica vaginalis enveloping the testis was brought into the abdominal cavity as a whole. When the tunica vaginalis was unable to be brought into the abdominal cavity, given that the orchiolysis had already been partially carried out, the testis could be brought out of the external ring and descended when converting to transscrotal surgery. Results: The mean age in this study was 1.88 years (standard deviation ±1.95). The position of the testis assessed at surgery was peeping (58, 36.7%) and canalicular (100, 63.3%). In 128 testes (81.1%), ALO brought the UDT into the abdominal cavity; the remaining 30 testes (18.9%) required a hybrid transscrotal technique. All testes were descended without conversion to open i...