The “Window” orchidopexy for prevention of testicular torsion

Recurrent torsion after previous testicular fixation

“…Use of non‐absorbable sutures has been limited by concerns regarding the occurence of chronic infection/granuloma formation, which may affect testicular function and lead to chronic testicular pain. Evidence from the animal studies confirms this with testicular abscess formation in large numbers of fixations using silk 4 …”

“…Two studies have investigated testicular fixation results for different surgical techniques in rat models. Morse and Hollabaugh evaluated four different fixation techniques 4 . They found that merely delivering the testis and returning it to the scrotum produced no adhesion formation when re‐explored at 2–5 weeks.…”

Orchiopexy for Intravaginal Testicular Torsion Ring-Shaped Fixation of the Lower Part of the Testis

“…With the conventional testicular fixation method for intravaginal testicular torsion, the testis was fixed in par allel with the long axis of the testis [1][2][3][4][5][6][7][8][9][10][11].…”

“…Various methods of testicular fixation have been tried to correct intravaginal testicular torsion [1][2][3][4][5][6][7][8][9][10][11], Those methods were to fix the intravaginal testis invested in the visceral layer of the tunica vaginalis to the scrotal wall through the parietal layer of the tunica vaginalis without any logical basis of the mechanism for testicular torsion. However, a testicular fixation method should ideally be developed by close anatomical study of the testis in the torsion and also of the normal one as a control.…”

Fixation of the testis

“…The discussion centred on whether one, two or three sutures should be used, and whether they should be absorbable or nonabsorbable [9–11]. In 1977, Morse and Hollabaugh [12] suggested a ‘window’ orchidopexy technique but this was not generally adopted and it still involved suture fixation of the testis. In 1985 Kuntze et al [10] reviewed the literature and found that an absorbable suture had been used in 15 of the 16 patients with recurrent torsion, and recommended the use of several 2/0 or 3/0 nonabsorbable sutures between the tunic albuginea and the scrotal wall.…”