Evaluation of two-staged Fowler–Stephens laparoscopic orchidopexy (FSLO) for intra-abdominal testes (IAT)

Bagga, Deepak; Prasad, Ashish; Grover, Shabnam Bhandari; Sugandhi, Nidhi; Tekchandani, Narender; Acharya, Samir; Samie, A

doi:10.1007/s00383-017-4170-8

Cited by 13 publications

(15 citation statements)

References 27 publications

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“…NPT accounts for 20–35% of UDT, and NPT patients often have short spermatic cord, which have been a challenge for surgeons ( 15 – 17 ). After the exclusion of non-viable testes, NPT can be classified into intra-abdominal and intracanalicular testes according to the location of the testis ( 4 , 15 ). Various surgical strategies are currently available to address this problem.…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Laparoscopic Orchiopexy With the Modified Prentiss Maneuver for Non-palpable Testis Near the Internal Ring

Tong

Wang

et al. 2022

Front. Pediatr.

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ObjectiveTo compare the clinical efficacy and safety of laparoscopic orchiopexy with the modified Prentiss maneuver (LOMPM) and laparoscopic trans-inguinal orchiopexy (LTIO) for the treatment of non-palpable testis (NPT) <1 cm from the internal ring.MethodsChildren with unilateral NPT who underwent laparoscopic orchiopexy at our center between February 2018 and January 2021 were retrospectively analyzed. According to the surgical method, they were divided into LOMPM and LTIO groups. The operation time, postoperative pain degree, postoperative complications and follow-up results were compared between the two groups.ResultsA total of 98 patients were included in this study, including 41 cases in the LOMPM group and 57 cases in the LTIO group. All patients underwent successful surgery. The LOMPM group was superior to the LTIO group in terms of postoperative testicular position (lower scrotm: 90.2 vs. 71.9%, P = 0.026). There were no significant differences in operation time, postoperative pain score, and complications between the two groups. Preoperative testicular volume, postoperative testicular volume, and testicular growth rate in the LOMPM group were comparable to those in the LTIO group. There were no testicular atrophy, inguinal hernia and hydrocele in both groups after operation.ConclusionsLOMPM was comparable in safety to LTIO, but LOMPM had a good post-operative testicular position, and was suitable for the treatment of NPT near the internal ring.

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Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of Laparoscopic Orchiopexy With the Modified Prentiss Maneuver for Non-palpable Testis Near the Internal Ring

Tong

Wang

et al. 2022

Front. Pediatr.

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“…15 Bagga et al reported a success rate of 68, 6% in the application of two-stage FS orchidopexy and they affirmed that two stages gave a better opportunity to achieve intrascrotal orchidopexy. 16 If we consider the complications of FSLO, the rate of atrophy reported in the large series varied from 4% to 17%. Alagaratnam et al found an incidence of testicular atrophy of 8.8% in 94 patients operated on with FS orchidopexy.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Fowler-Stephens orchidopexy for intra-abdominal cryptorchid testis: a single institution experience

Papparella

Rosa

Noviello³

2021

Pediatr Med Chir

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Fowler-Stephens Laparoscopic Orchiopexy (FSLO) permits the mobilization of Intra-Abdominal Testis (IAT) to the scrotal position after spermatic vessel ligation. We reported our experience of FSLO for IAT. The charts of all boys who underwent a FSLO were retrospectively reviewed. Data were analysed for demographic data, procedure, complications and follow-up results. From January 2008 to June 2016, 160 laparoscopies for Non Palpable Testis (NPT) were performed at a mean age of 3,2 years. 61% of patients had a right NPT, while 6% were bilateral. In 64 cases, an IAT was found: 20 were managed by FSLO with a two-stage procedure in 11 patients. There were no differences in hospitalisations; one patient had a prolonged ileus. Follow-up ranged from 1 to 8 years. Of the 20 patients who underwent FSLO, testicular atrophy developed in three; the remaining testes were in the scrotal position, with normal consistency. FSLO was applied in 31% of IAT. The overall success rate of the technique was 85 %. The percentage of atrophy associated after spermatic vessels interruption appears to provide a good chance of testicular survival.

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“…Post-operative outcome reporting is variable, but includes testicular atrophy, ascent, and volume discrepancy compared to the contralateral testis. Successful outcomes (a testis in the scrotum) have been reported at 66.7-92% [14][15][16][17][18][19] for FSLO, with a systematic review indicating an overall 85% success rate [20]. However, some authors have reported significantly smaller post-operative testicular volumes compared with the contralateral, normally descended testis [17].…”

Section: Discussionmentioning

confidence: 99%

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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Evaluation of two-staged Fowler–Stephens laparoscopic orchidopexy (FSLO) for intra-abdominal testes (IAT)

Cited by 13 publications

References 27 publications

Clinical Efficacy of Laparoscopic Orchiopexy With the Modified Prentiss Maneuver for Non-palpable Testis Near the Internal Ring

Clinical Efficacy of Laparoscopic Orchiopexy With the Modified Prentiss Maneuver for Non-palpable Testis Near the Internal Ring

Laparoscopic Fowler-Stephens orchidopexy for intra-abdominal cryptorchid testis: a single institution experience

Staged laparoscopic traction orchidopexy for impalpable testes: a preliminary study

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