Preliminary ligation of the gonadal vessels prior to orchidopexy for the intra-abdominal testicle

Ransley, Philip G.; Vordermark, Jonathan S.; Caldamone, Anthony A.; Bellinger, Mark F.

doi:10.1007/bf00326700

Cited by 128 publications

(39 citation statements)

References 5 publications

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“…Orchiopexy by inguinal approach and laparoscopic orchiopexy without ligation of vessels presented a surgical success (adequate testicular volume and position) of 89%, whereas laparoscopic orchiopexy in 2 stages (FowlerStephens), obtained 77% of good results; values that are consonant to the literature (13)(14)(15)(16).…”

Section: Discussionsupporting

confidence: 72%

“…Autotransplantation, that is not performed in our service as well, requires microvascular surgery techniques and a prolonged hospitalization time (11,12). The ligation of spermatic vessels, as postulated by Fowler & Stephens, has a testicular atrophy index around 30% (13,14); that can be lowered to about 10%, when the procedure is per-formed in 2 stages, allowing the development of collateral circulation (15).…”

Section: Discussionmentioning

confidence: 99%

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The role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testis

et al. 2003

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Objective: Evaluate the results from the first 5 years of experience with laparoscopy for diagnosis and treatment of nonpalpable testes.Materials and Methods: Medical records of 51 patients submitted to laparoscopic testicular exploration, during a 5-year period, were retrospectively analyzed. Patients' mean age was 65.7 months (median = 48) on the first procedure. The youngest patient was 10 months and the oldest was 14 years old on the first surgery. Twenty-four (47%) patients presented nonpalpable testes bilaterally, 7 (14%) only at the right side and 20 (39%) at the left, totaling 75 testicular units assessed. Patients who had their testes palpated after anesthetic induction were excluded from the study, and in all other cases, surgical management was based on the testicular position and viability. During the post-operative follow-up, surgical success was classified as palpable testis in scrotal sac, with adequate consistency and volume.Results: Nine (12%) testes were not localized, but their vessels and deferent duct were atrophic. Two (3%) testes were intra-abdominal and atrophic, and 2 (3%) gonads, in the same patient, had a dysmorphic aspect. Nineteen (25%) testicular units were located close to the internal inguinal ring (peeping testes) and, in 22 (29%) units, the spermatic vessels and deferent duct penetrated the internal inguinal ring. Eight (10%) testes were located at a distance of less than 2 cm from the internal inguinal ring and 13 (17%) at a distance greater than 2 cm. The 2 intra-abdominal atrophic testes were removed. Inguinotomy was performed in a total of 41 (54%) cases, reaching a surgical success of 89%. Laparoscopic orchiopexy in one stage, without vascular ligation, was performed in 9 (12%) testes, which presented a distance of less than 2 cm from the internal inguinal ring, also with a surgical success index of 89%. Orchiopexy in 2 stages, with ligation of the spermatic vessels, was performed in 13 (17%) testicular units located at a distance greater than 2 cm from the internal inguinal ring, reaching 77% of good results.Conclusion: Videolaparoscopy is a safe and effective method for diagnosis and treatment of nonpalpable testis.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

The role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testis

et al. 2003

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“…In our unit, we recommend orchiopexy for impalpable testis before the age of 12 months. However, because of late presentation and/or referrals, the mean age at surgery was 6.1±4.2 years (range [2][3][4][5][6][7][8][9][10][11][12]. This may explain the high rate of small and abnormal appearance of the testes, compared with the contralateral testes and also the relatively low success rate.…”

Section: Discussionmentioning

confidence: 99%

“…The technique was originally a one-stage procedure. In 1984, Ransley et al [3] introduced the two-stage procedure, anticipating development of collateral blood supply after dividing the testicular vessels. Today, FSO is performed either one-or two-stage procedures.…”

Section: Introductionmentioning

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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“…Nowadays, the atrophy rates, resulting from testicular desvacularization, still high [9][10][11] . Autotransplantation was tried, but few results have been showed, especially in small children 12 .…”

Section: Discussionmentioning

confidence: 99%

Testicular histology after intestinal pedicle flap (cecum) apposition in rats

et al. 2010

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Purpose: Histological study of vascularization between a cecal pedicle flap and the testicle of Wistar rats. Methods: Fifty-three rats were studied. G1: submitted to celiotomy (a), mobilization of the right testicle (RT) to the abdomen (b), cecal flap suture to the RT (d) and cavity closure. G1: procedures a, b and d and fixation of RT into abdomen. G3: procedures a, b and d, exposition of RT to air and reposition into scrotum. G4: not operated. Euthanasia and histology was done after 20 days. Histometry and lesions score classification was done. Testicular vascularization was studied with comparison between G1 and G3. A p < .05 was considered significant. Results: The G1 RT diameters were not different to G2 RT and all have decreased size in comparison with RT of G3 and G4. The lesions score in the RT was 5.83 in G1 and 3.3 in G2 without statistical difference. The vascularization's average in G1 was 16.9 vessels in 400X field in the RT. In the G3 this average was 0.96 to the RT and 0.92 to left testicles. The weight's average in G1 was similar with G2 but different of G3 and G4. Conclusion: A significant increase of vascularization was observed between the intestinal flap and the rat testicle. Key words: Testis. Surgical Flaps. Histology. Rats. RESUMOObjetivos: Estudar histologicamente a vascularização entre um retalho cecal e o testículo de ratos Wistar. Métodos: Cinquenta e três ratos foram estudados. G1, submetidos a (a) celiotomia, (b) mobilização do testículo direito (TD) para o abdome, (c) sutura do retalho cecal ao TD, (d) fechamento da cavidade. G2, procedimentos (a, b e d), com o TD fixado no abdome. G3, procedimentos (a, b e d), com exposição do TD ao ar e retorno ao escroto. G4 não operados. Após 20 dias, eutanásia e histologia. Realizou-se histometria e classificação segundo escore de lesão. Avaliou-se a vascularização testicular, comparando-se os grupos 1 e 3. Considerou-se significativo um p < 0,05. Resultados: Diâmetros dos TD no G1, iguais ao G2 e diferentes de G3 e G4. O escore de lesão nos TD foi de 5,83 pontos para o G1, de 3,3 pontos para o G2, não havendo diferença significativa, porém diferentes de G3 e G4 (sem lesão). A vascularização no G1 teve média de 16,9 vasos por campo de grande aumento no TD. No G3 a média foi de 0,96 no TD e 0,92 no TE, com diferença significativa. O peso médio do G1 foi igual ao G2 e diferente de G3 e G4. Conclusão: Houve aumento significativo da vascularização entre o retalho e o testículo do rato. Descritores: Testículo. Retalhos Cirúrgicos. Histologia. Ratos.

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Preliminary ligation of the gonadal vessels prior to orchidopexy for the intra-abdominal testicle

Cited by 128 publications

References 5 publications

The role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testis

The role of videolaparoscopy in the diagnostic and therapeutic approach of nonpalpable testis

Laparoscopic one-stage Fowler-Stephens orchiopexy preserving gubernaculum

Testicular histology after intestinal pedicle flap (cecum) apposition in rats

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