Initial Success with Gubernacular-Sparing Laparoscopic-Assisted Fowler-Stephens Orchidopexy for Intra-abdominal Testes

Mahomed, Anies; Adams, Stephen D.; Islam, Saidul

doi:10.1089/lap.2011.0130

Cited by 14 publications

(6 citation statements)

References 9 publications

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“…Instead, a higher incidence of ascent approaching significance (multivariate analysis p Z 0.08) was noted for passing the testis through the deep ring and canal rather than forging a more direct path through the conjoint tendon. Additional groin incision for preservation of the gubernacular vessels has been proposed, with good results in one small series [27]. In our cohort, the gubernaculum was documented to have been preserved in only four of 40 testes routed through the deep ring and inguinal canal without discernible statistically significant benefit for atrophy or ascent.…”

Section: Discussionmentioning

confidence: 60%

Testicular outcome following laparoscopic second stage Fowler–Stephens orchidopexy

Alagaratnam

Nathaniel

Cuckow

et al. 2014

Journal of Pediatric Urology

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Section: Discussionmentioning

confidence: 60%

Testicular outcome following laparoscopic second stage Fowler–Stephens orchidopexy

Alagaratnam

Nathaniel

Cuckow

et al. 2014

Journal of Pediatric Urology

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“…[8][9][10][11][12] Robertson et al [13] and Mahomed et al [14] reported 86% (18 of 21 testis); and 100% (18 of 18 testis) testicular survival rates, respectively for two-stage gubernaculum-sparing laparoscopic FSO procedures resembling our technique. Our success rate for laparoscopic onestage FSO was 71.1%.…”

Section: Discussionmentioning

confidence: 53%

“…On the contrary, in the series of Robertson et al [13] , only 5 of the 18 testes in their series were mentioned to be small with abnormal appearance; and only 5 of the 18 testes were in a high intrapelvic position. In the series of Mahomed et al [14] no commend was made on testicular morphology or intrapelvic location of testes. In our unit, we recommend orchiopexy for impalpable testis before the age of 12 months.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic one-stage Fowler-Stephens orchiopexy preserving gubernaculum

Naycı

Bahadır

Erdoğan

et al. 2017

Turkish Journal of Urology

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Objective: To assess gubernaculum-sparing laparoscopic one-stage Fowler-Stephens orchiopexy (FSO), in the management of high intrapelvic testis. Material and methods:Medical reports of boys who underwent laparoscopic one-stage FSO were retrospectively reviewed. High intrapelvic testis was defined as testis ≥3 cm away from ipsilateral internal ring. Testes were evaluated on physical examination at 3 rd , 6th and 18 th months after surgery. Children were evaluated as for their demographic data, operative findings, interventional details and outcomes.Results: Seven patients met inclusion criteria of the study. Six of 7 testis were small and had abnormal appearance, compared with the contralateral testis. Average distance of the testes from the internal ring was 4.2±1.1 cm (3 to 6). Average age at surgery was 6.1±4.2 years (2 to 12). Average follow-up period was 14±5.8 months (8 to 20), and 5 testis (71.4%) were considered to be normal in volume and scrotal location. Two testes were relatively atrophic and underwent orchiectomy. Conclusion:Our preliminary results shows a good testicular survival rate for one-stage laparoscopic FSO. Sparing collateral vasculature of the gubernaculum is important.

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“…The conventional second-stage FSO incises the gubernaculum and passes the testis medial to the inferior epigastric vessels to obtain the shortest route to the scrotum. 17 Alagaratnam et al retrospectively studied cases treated with staged FSO and reported an 8.8% rate of testicular ascent. They proposed that mobilization of the testes through the inguinal canal carries a greater risk of ascent versus passage through a new path medial to the inferior epigastric vessels.…”

Section: Discussionmentioning

confidence: 99%

Open Versus Laparoscopic Gubernaculum-Sparing Second-Stage Fowler–Stephens Orchiopexy for Intra-Abdominal Testis: A Long-Term Study

Zhou

Chen

Yin

et al. 2022

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: The benefits of performing open versus laparoscopic gubernaculum-sparing second-stage Fowler–Stephens orchiopexy (FSO) remain unclear. We compared the two techniques to answer this question. Methods: We retrospectively studied a cohort of patients who underwent laparoscopic first-stage FSO and open versus laparoscopic gubernaculum-sparing second-stage FSO at our institution between September 2004 and June 2020 (all patients underwent surgery by a single surgeon). We evaluated both procedures based on the incidence of testicular atrophy, testicular ascent, and other complications. Results: The age at initial surgery was 45.7 ± 28.2 months (median, 39). One hundred nine cases were treated with open second-stage gubernaculum-sparing FSO (OFSO), and 96 cases were treated with laparoscopic second-stage gubernaculum-sparing FSO (LFSO). The mean follow-up period was 59.8 months (median, 54; standard deviation, +35). The overall testicular atrophy rate was 1.5%. Atrophy was observed in 2 and 1 patient in the OFSO and LFSO groups, respectively (1.8% versus 1.0%, P > .05). There was no significant difference in the incidence of testicular ascent between both groups (2.8% versus 3.1%). Five and four complications were noted in the OFSO and LFSO groups, respectively ( P > .05). Conclusions: Second-stage gubernaculum-sparing FSO achieved high testicular survival rates and satisfactory testicular positions. Neither the open nor laparoscopic approach appeared superior, because the overall testicular survival rates and incidence of testicular ascent and other complications were equivalent between both groups.

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Initial Success with Gubernacular-Sparing Laparoscopic-Assisted Fowler-Stephens Orchidopexy for Intra-abdominal Testes

Cited by 14 publications

References 9 publications

Testicular outcome following laparoscopic second stage Fowler–Stephens orchidopexy

Testicular outcome following laparoscopic second stage Fowler–Stephens orchidopexy

Laparoscopic one-stage Fowler-Stephens orchiopexy preserving gubernaculum

Open Versus Laparoscopic Gubernaculum-Sparing Second-Stage Fowler–Stephens Orchiopexy for Intra-Abdominal Testis: A Long-Term Study

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