caa a22 4500 475779606 CHVBK 20180406123640.0 cr unu---uuuuu 170329e20000701xx s 000 0 eng 10.1007/s004640000107 doi (NATIONALLICENCE)springer-10.1007/s004640000107 Laparoscopic orchiopexy without division of the spermatic vessels [Elektronische Daten] Can it be considered the procedure of choice in cases of intraabdominal testis? [C. Esposito, G. Vallone, A. Settimi, M. A. Gonzalez Sabin, G. Amici, T. Cusano] Background: Several surgical procedures have been described for the management of nonpalpable testis. Following a vast experience with a complete laparoscopic two-stage Fowler-Stephens procedure, we report our experience with laparoscopic orchiopexy performed without dividing the spermatic vessels. Methods: Over a 24-month period, 70 boys with nonpalpable testes (72 overall) underwent laparoscopic diagnostic exploration. Twenty patients (27.8%) of this series who showed an intraabdominal testis underwent laparoscopic orchiopexy without sectioning the spermatic vessels. In seven cases, the testis was just proximal to the internal inguinal ring; in 13, it was in the high intraabdominal position. The technique consisted in sectioning the gubernaculum (when present), opening the peritoneum laterally to the spermatic vessels, and mobilizing the testicular vessels and the vas deferens in a retroperitoneal position for 8-10 cm. The testis was then brought down into the scrotum through the internal inguinal ring (11 cases), if this was open, or through a neo-inguinal ring (nine cases) created medially to the epigastric vessels. In every case, we closed the inguinal ring at the end of the operation using one or two detached sutures. Results: Operating time ranged between 40 and 75 min (median, 55). All the testes were successfully brought down into the scrotum. We had only one (5%) intraoperative complication. In the second patient treated with this procedure, there was an iatrogenic rupture of the spermatic vessels due to excessive traction. Conclusion: On the basis of our experience, we believe that laparoscopic orchiopexy without division of the spermatic vessels should be the treatment of choice in the management of nonpalpable testes, because it does not affect normal testicular vascularization and is minimally invasive. A blunt dissection and a delicate manipulation of the testis without excessive traction are the best ways to avoid any kind of complication. Springer-Verlag New York Inc., 2000 Key words: Children — Fowler-Stephens procedure — Laparoscopy — Orchiopexy — Testis nationallicence Esposito C. Magna Graecia University of Catanzaro and Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 8031 Naples, Italy, Italy aut Vallone G. Department of Radiology, Federico II University of Naples, Via Pansini 5, 8031 Naples, Italy, Italy aut Settimi A. Magna Graecia University of Catanzaro and Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 8031 Naples, Italy, Italy aut Gonzalez Sabin M. A. Department of Pediatric Surgery, William Soler University Hospital, Major Street, La Habana, Cuba, Cuba aut Amici G. Magna Graecia University of Catanzaro and Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 8031 Naples, Italy, Italy aut Cusano T. Division of Pediatric Surgery, University of Ancona, Via Salesi 10, Ancona, Italy, Italy aut Surgical Endoscopy Springer-Verlag 14/7(2000-07-01), 658-660 0930-2794 14:7<658 2000 14 464 https://doi.org/10.1007/s004640000107 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000107 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Esposito C. Magna Graecia University of Catanzaro and Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 8031 Naples, Italy, Italy aut NATIONALLICENCE 700 1- Vallone G. Department of Radiology, Federico II University of Naples, Via Pansini 5, 8031 Naples, Italy, Italy aut NATIONALLICENCE 700 1- Settimi A. Magna Graecia University of Catanzaro and Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 8031 Naples, Italy, Italy aut NATIONALLICENCE 700 1- Gonzalez Sabin M. A. Department of Pediatric Surgery, William Soler University Hospital, Major Street, La Habana, Cuba, Cuba aut NATIONALLICENCE 700 1- Amici G. Magna Graecia University of Catanzaro and Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 8031 Naples, Italy, Italy aut NATIONALLICENCE 700 1- Cusano T. Division of Pediatric Surgery, University of Ancona, Via Salesi 10, Ancona, Italy, Italy aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/7(2000-07-01), 658-660 0930-2794 14:7<658 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer