Early Clinical Outcome of Staged Laparoscopic Traction Orchidopexy for Abdominal Testes

Abouheba, Mohamed; Younis, Wagdy; Elsokary, Ahmed; Roshdy, Walid; Waheeb, Saber

doi:10.1089/lap.2018.0171

Cited by 16 publications

(11 citation statements)

References 11 publications

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“…This study presents the first results of SLTO performed in the UK to date, and confirms similar outcomes to the available international literature [22][23][24]. The study was limited, however, by a small sample size and short follow-up.…”

Section: Discussionsupporting

confidence: 84%

“…Shehata et al published a series of 140 cases of SLTO for IAT, and described a traction suture slippage rate of 11% and overall success rate of 84% [22]. More recently, the same authors replicated their technique on 34 IAT with similar slippage rates and 100% of fixed testes were seen to be well vascularized on Doppler ultrasound at follow-up [23]. Further studies investigating the feasibility of SLTO have reported suture slippage and failure of elongation of the vascular pedicle each at 9% with 0% atrophy [24].…”

Section: Discussionmentioning

confidence: 98%

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Staged laparoscopic traction orchidopexy for impalpable testes: a preliminary study

2019

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Purpose Laparoscopy is the gold standard to assess for presence of an intra-abdominal testis. However, techniques for the subsequent orchidopexy vary, and include the recently described staged laparoscopic traction orchidopexy (SLTO) (Shehata in Pediatr Surg 51(2):211-215, 2016). SLTO enables elongation of the testicular vessels without division, with initial success rates reportedly superior to Fowler-Stephens. We present the first UK data following a preliminary study using SLTO. Methods 19 boys prospectively presenting with 22 intra-abdominal testes (IAT) underwent STLO in a single centre, with a median age of 2.5 years (IQR 1.4-5.2) at first stage. 3/19 (16%) boys had bilateral IAT and nine (41%) were left-sided. Pneumoperitoneum was established using 5 mm umbilical and 3 mm accessory ports in bilateral iliac fossae. The gubernaculum and lateral peritoneal attachments were divided prior to securing the intra-abdominal testis to the contralateral anterior abdominal wall with 2/0 Ti-cron™. Second-stage procedures were planned for 3-6 months later. The securing stitch was cut; an 11 mm STEP port was placed trans-scrotally to retrieve the testis and secured in a sub-dartos pouch. Outcome measures included palpable testes in the scrotum and surgical complications. Results 13/22 IAT have undergone follow-up. Twelve (92%) IAT were palpable in the scrotum following SLTO. There was one diathermy-related bladder injury necessitating laparoscopic repair, and 3/22 (13.6%) slipped sutures, requiring repeat first-stage procedures. Conclusions Staged laparoscopic traction orchidopexy is a feasible technique, which can be performed as an alternative to Fowler-Stephens procedure, with potentially better outcomes for the testis. The complications described should be preventable as the technique evolves.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 98%

Staged laparoscopic traction orchidopexy for impalpable testes: a preliminary study

2019

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“…Regardless of the fact that Shehata technique has many advantages, it also has limitations. Abouheba et al (13) reported that in their study, three of 34 testicles in older boys occasionally experienced testicular slippage after traction and fixation. In addition, one child with bilateral IAT was observed to have fusion of both testes concurrently during the 2nd-stage of laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 83%

“…However, this method has some limitations, such as two-stage waiting time is long (6 months), and spermatic cord blood vessels need to be transected (20,21). It has been reported that laparoscopic-assisted traction testicular fixation of high IAT quickly attracted the attention and application of the majority of scholars (13,22). Shehata improved the theory of testicular traction on the basis of previous scholars (12).…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Two Types of Staged Laparoscopic Orchiopexy for High Intra-Abdominal Testes in Children: A Retrospective Study From a Single Center

et al. 2021

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Background: To evaluate the efficacy and safety of 2nd-stage laparoscopic traction orchiopexy (Shehata technique) compared to Fowler-Stephens (F-S technique) for high intra-abdominal testes (IATs) in children.Patients and Methods: We performed a retrospective review of all children (<14 years old) who underwent laparoscopic treatment of high IAT in the pediatric surgery center of Yijishan Hospital of Wannan Medical College from April 2016 to April 2020. Participants were divided into the Fowler-Stephens (F-S) group and Shehata group according to the surgical method. We collected the medical records of all children and analyzed them statistically.Results: In this study, 43 patients in our center received 2nd-stage laparoscopic surgical treatment. The results showed that there were 23 high IATs in 22 patients in the F-S group and 22 IATs in 21 patients in the Shehata group. All patients completed the operation successfully. No significant difference in operation time was noted between the two groups. There was no significant difference in the testicular atrophy rate between the two groups (P = 0.323). The testicular retraction rate of the F-S group was greater than that of the Shehata group (P = 0.04).Conclusion:The results of this study indicate that the application of assisted laparoscopic testicular traction technology can effectively retain the main blood supply of the testis and vas deferens with a high survival rate and clear advantages. The preliminary results show that the Shehata technique is safe, reliable and effective in the treatment of high IAT in children.

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Laparoscopic Management of Intra-abdominal Testis (Shehata Technique)

Shehata

2021

Video Atlas of Pediatric Endosurgery (VAPE)

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Early Clinical Outcome of Staged Laparoscopic Traction Orchidopexy for Abdominal Testes

Cited by 16 publications

References 11 publications

Staged laparoscopic traction orchidopexy for impalpable testes: a preliminary study

Staged laparoscopic traction orchidopexy for impalpable testes: a preliminary study

Comparison of Two Types of Staged Laparoscopic Orchiopexy for High Intra-Abdominal Testes in Children: A Retrospective Study From a Single Center

Laparoscopic Management of Intra-abdominal Testis (Shehata Technique)

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