Management of the Looping Vas Deferens During Laparoscopic Orchiopexy

Shalaby, Mahmoud; Shoma, Ahmed M.; El-Anany, Fathy; ElGanainy, Ehab O.; El-Akkad, M. M.

doi:10.1016/j.juro.2011.01.033

Cited by 9 publications

(7 citation statements)

References 6 publications

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“…In childhood age does not limit the application of laparoscopy because now it has opticians, trocars and surgical material from 1.7 mm in diameter and can be performed even in neonates. In the pediatric use of laparoscopy as an exploratory procedure it is highly profitable and in some cases irreplaceable [6,10].…”

Section: Discussionmentioning

confidence: 99%

“…It may be unilateral or bilateral less frequently, with partial or complete absence of testicular tissue and in most cases with normal external genitalia. Patients are usually male phenotype; the spectrum can range from normal male unilateral non-palpable cases with micropenis phenotypically male to female or phenotypically [6,7]. The phenotype likely to depend on the extent and timing of intrauterine accident.…”

Section: Case Reportmentioning

confidence: 99%

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Testicle Evanescent in Pediatric Urology: Laparoscopic Management

P¹

2016

OAJUN

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Testicular regression syndrome or evanescent testis is a clinical condition that arises from atrophy and disappearance of normal testis in the fetal period. Anatomically it is characterized by a spermatic cord with no identifiable macroscopically testicular tissue. The absence of a testicle in a man 46XY is usually unilateral and arises from a twist or an intrauterine or perinatal stroke. The clinical case of male 2 years 6 months old, a product of the second pregnancy, which comes to evaluation, is presented cryptorchidism left. On physical examination, genital according to age and sex, good gonadal development, normal penis and foreskin, right testicle in scrotal sac, about 12 mm, left no palpable. It inguino-escrotal ultrasound with left empty scrotal sac, no left testicle, right scrotal sac with normal testicle is identified. MRI was performed showing only right testicle in the scrotum. Diagnostic laparoscopy was performed, finding in the groin area on the right side the path of vas deferens normally and gonadal vessels of good caliber in the inguinal ring, on the left side, vas deferens was found dead-end and absence of gonadal vessels and the inguinal ring closed. Laparoscopy is the most effective and most widely accepted for non-palpable testicle therapeutic diagnostic method because it provides access to the abdominal cavity and high visibility, with the known advantages of laparoscopy in terms of postoperative recovery, also applicable to pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Testicle Evanescent in Pediatric Urology: Laparoscopic Management

P¹

2016

OAJUN

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“…If a long looping vas deferens is present, the surgeon should use only blunt dissection without thermal energy to carefully dissect it away from the gubernaculum and bring it into the abdomen. 30 If there is any difficulty bringing the full extent into the abdomen or other concern, either an inguinal or scrotal incision can be made to aid with dissection. 20,30 …”

Section: Special Situationsmentioning

confidence: 99%

“…30 If there is any difficulty bringing the full extent into the abdomen or other concern, either an inguinal or scrotal incision can be made to aid with dissection. 20,30 …”

Section: Special Situationsmentioning

confidence: 99%

The Nonpalpable Testis: A Narrative Review

Shepard

Kraft

2017

Journal of Urology

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Purpose While the nonpalpable testis represents only a small portion of all cryptorchid testes, it remains a clinical challenge for pediatric urologists. Many controversies about the best evaluation and management exist. This narrative review serves as an update on what is known about the nonpalpable testis: etiology, pre-operative evaluation, the best surgical management, novel techniques, and ongoing controversies. Materials and Methods A Pubmed® and MEDLINE® search limited to January 2000 to January 2017 was performed using relevant key terms. Of 367 articles, a total of 115 manuscripts were considered for inclusion based on an a priori design. Utilizing a narrative review format, an update on the evaluation and management of the nonpalpable testis including novel concepts and techniques was synthesized. Results The nonpalpable testis should be evaluated by physical exam only. Imaging is not indicated for the routine case. The optimal surgical approach and technique remains debated, but several novel techniques have been described. Due to the rarity of the nonpalpable testis, randomized controlled trial and other quality comparisons are difficult. Therefore, several controversies in management remain. Conclusions The evaluation and management of the nonpalpable testis remains difficult and some aspects remain debated. Future research should focus on multi-institutional collaborative trials to determine the optimal operative management.

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“…The dissection of the internal spermatic vessels together with the shortcut during orchidopexy offer extra length and tensionfree orchidopexy that the inguinal procedure cannot specially for older children. The long looping vas deferens also is not a contraindication for laparoscopic management, [1] hence, the question whether open surgery still has a role or not appears justified.…”

mentioning

confidence: 99%

Is there a role for open surgery in the management of the undescended testis?

Shalaby¹

2012

Afr J Paediatr Surg

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Management of the Looping Vas Deferens During Laparoscopic Orchiopexy

Cited by 9 publications

References 6 publications

Testicle Evanescent in Pediatric Urology: Laparoscopic Management

Testicle Evanescent in Pediatric Urology: Laparoscopic Management

The Nonpalpable Testis: A Narrative Review

Is there a role for open surgery in the management of the undescended testis?

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