The outcome of laparoscopic assisted orchidopexy in very young children: A single hospital experience

Hindi, Saeed Al; Khalaf, Zahra

doi:10.1016/j.jpurol.2021.03.004

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…At laparoscopy, 10 testes were identified above the internal ring, 5 near iliac vessels, and 4 close to the kidney. During follow-up, there was not a single case of testicular atrophy, and the overall success rate was 89.5% [12]. Similar findings were noted in another study by Alzahem, who reported significantly better outcomes when vessel-preserving laparoscopic orchiopexies were performed.…”

Section: Discussionsupporting

confidence: 85%

“…In a single-stage laparoscopic orchidopexy, the vas deferens and the spermatic blood vessels are detached and mobilized, and the testicle is then lowered into the subcutaneous pocket of the scrotum in the same act. The prerequisite for a single-stage laparoscopic orchidopexy is that the testicle can be pulled to the contralateral inguinal opening without tension after mobilizing the vas deferens and spermatic vessels [12,13].…”

Section: Introductionmentioning

confidence: 99%

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The Safety and Effectiveness of Single-Stage, Vessel-Preserving, Laparoscopic Orchiopexy for Intra-Abdominal Testes in Pediatric Patients: A 10-Year Single-Center Experience

Pogorelić,

Šitum,

Barić

et al. 2024

JCM

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Objectives: Intra-abdominal testes are located in a variety of intra-abdominal positions, most less than 2 cm from the internal ring. Various surgical techniques of laparoscopic orchiopexy have been described to date. The aim of this study was to evaluate the safety and long-term efficacy of a single-stage, vessel-preserving, laparoscopic orchiopexy for intra-abdominal testes in pediatric patients. Methods: A retrospective search of the medical records of 32 children (34 testes) who underwent single-stage, vessel preserving, laparoscopic orchiopexy for intra-abdominal testes between 1 January 2014 and 31 December 2023 was performed. Single-stage laparoscopic orchiopexies were performed in all patients for whom sufficient length of the spermatic cord was achieved during the procedure. The volume of each patient’s testes was measured using ultrasound before and 6 months after laparoscopic orchiopexy. The main outcome of this study was testicular volume before and after the procedure. The secondary outcomes were the occurrence of early and late complications, the duration of surgery, and the length of hospital stay. Results: The median age at the time of surgery was 10 months (interquartile range—IQR 9, 13). The majority of the children (n = 24; 75%) were less than 12 months old at the time of surgery. A normal testis was found in 24 patients (70.6%), while a hypotrophic testis was visible in 10 cases (29.4%). The majority of the testes were located near the internal ring (n = 19; 55.9%), while in the remaining cases, the testes were located near the iliac blood vessels. The median duration of the surgical procedure was 37.5 min (IQR 33, 42.5). The duration of hospitalization was one day for all the children. No intraoperative complications were observed. One child had a wound infection at the site of the umbilical trocar, which was treated conservatively. In two cases (5.5%), testicular atrophy was detected during long-term follow-up. In three cases, the testis was found in a higher position in the scrotum during the follow-up period, but in two cases, the position was normal during the follow-up period, while in one case, the position in the scrotum remained unchanged. At long-term follow-up with a median of 35 months (IQR 19, 60.5), the overall success rate was 94.5%. The median testicular volume at 6-month follow-up increased from 0.31 mL (IQR 0.28, 0.43) to 0.40 mL (IQR 0.33, 0.53) (p = 0.017). Conclusions: Single-stage, vessel-preserving, laparoscopic orchiopexies for intra-abdominal testes are safe and effective in pediatric patients in whom adequate spermatic cord length can be achieved during the procedure.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

The Safety and Effectiveness of Single-Stage, Vessel-Preserving, Laparoscopic Orchiopexy for Intra-Abdominal Testes in Pediatric Patients: A 10-Year Single-Center Experience

Pogorelić,

Šitum,

Barić

et al. 2024

JCM

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“…C-reactive protein (CRP) and procalcitonin are released by IL-6, which stimulates hepatic acute-phase protein synthesis. The amount of IL-6 secreted correlates with the severity of the trauma, the length of surgery, and the risk of postoperative complications [12][13][14][21][22][23][24][25][26].…”

Section: Results and Dissectionmentioning

confidence: 99%

Untitled

2021

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Laparoscopy is a minimally invasive surgery using advanced technology, so the resulting surgical wound is smaller than conventional surgery. Laparoscopy, especially in the field of urology, is known to cause complications in patients. Intraoperative complications will cause physiological stress that causes an inflammatory response in the body. Neutrophils are one of the most important cells in producing the inflammatory response in the acute phase. Meanwhile, lymphocytes are the main cellular components of the immune system that are mediated by T cells and humoral cells. This study was conducted retrospectively and reviewed the patient's medical record data from intraoperative to outpatient admission. The sample included 71 patients who underwent laparoscopic urology in 2017-2019. There was a difference in NLR values between pre surgery and post-surgery (p <0.05). It is known that the postoperative NLR value is higher than preoperative. In addition, it was known that there were differences in postoperative NLR values between patients who did not experience complications and those who had complications (p < 0.05). Where there is an increase in the postoperative NLR value in patients with complications, intraoperative complications lead to increased NLR. The greater the physiological stress experienced, the higher the NLR value. Increased NLR reflects poor output.

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“…The recommended age for orchiopexy for an undescended testis has declined further over the years. In the 2000s, surgery was recommended between the ages of 1 and 2 years, while today it is currently recommended between 6 and 18 months [3]. In the guideline published by the European Association of Urology in 2019, it is recommended that any treatment for undescended testicles should be completed up to twelve months or by eighteen months at the latest [6].…”

Section: Kocaman Oh Et Al Laparoscopy Experiences In the Non-palpable...mentioning

confidence: 99%

“…It is seen in 3 to 5% of term newborn boys, while the incidence decreases to 1.5 to 3% at 6 months of age due to postnatal migration [1,2]. Undescended testicles can be classified according to their position as peeping (glides in and out of the inner inguinal ring), canalicular, extra canalicular (superficial inguinal pouch), suprapubic (high scrotal) or intraabdominal [3]. Some 20 to 25% of non-palpable testicles are in the intra-abdominal space and 65% are in the inguinal canal.…”

Section: Introductionmentioning

confidence: 99%

Our experiences of laparoscopy in the non-palpable testes

Kocaman

Günendi

2022

Acta Medica Alanya

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AIM: To demonstrate the superiority of laparoscopic undescended testicular surgery for nonpalpable testicles in children in diagnosis and treatment. METHODS: The files of patients between the age of 6 months-18 years who underwent laparoscopic undescended testis investigation due to nonpalpable testis in our clinic between January 2010 and September 2021 were reviewed retrospectively. Patients with palpable testicles and patients with disorders of sex development in the examination performed under general anesthesia were excluded from the study. RESULTS: 53 patients were included in the study. The mean age of the patients is 3.2 years (min: 8 months-max 17 years). Laparoscopic intervention was performed for a total of 59 nonpalpable testicles which were left-sided in 54.7% (n=29) of the patients, right-sided in 34% (n=18), and bilateral in 11.3% (n=6). Throughout these 59 testicles, cords and vessels of 31 testicles were visualized entering the inguinal canal, atrophic testes in the abdomen were detected in 7 patients, the cord and vessels had an intraabdominal blind ending (vanishing testis) in 7 patients, and 14 testicles were in the abdomen with normal aspect. CONCLUSION: Simultaneous laparoscopic orchiectomy is performed in case of atrophic testis in laparoscopic exploration for nonpalpable testicles. It allows the ligation of vessels of testes farther than 2 cm away from the inguinal canal, and for testes that are closer than 2 cm it grants the vessels to be released under a more precise vision thereby protecting from the complications of conventional surgery.

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The outcome of laparoscopic assisted orchidopexy in very young children: A single hospital experience

Cited by 5 publications

References 23 publications

The Safety and Effectiveness of Single-Stage, Vessel-Preserving, Laparoscopic Orchiopexy for Intra-Abdominal Testes in Pediatric Patients: A 10-Year Single-Center Experience

The Safety and Effectiveness of Single-Stage, Vessel-Preserving, Laparoscopic Orchiopexy for Intra-Abdominal Testes in Pediatric Patients: A 10-Year Single-Center Experience

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Our experiences of laparoscopy in the non-palpable testes

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