Objective: The laparoscopic approach was evaluated in the diagnosis and treatment of the cases with non-palpable testis in childhood.
Material and Methods: A total of 10 pati-ents were evaluated between the dates of De-cember 2010 and July 2011. All of the patients were evaluated with detailed history, physi-cal examination, ultrasonography and magne-tic resonance imaging before the surgery. Lapa-roscopic procedure was performed to 10 cases with non-palpable testis, four of whom could be detected with magnetic resonance imaging and six of whom could not be detected with the physical examination and the methods of the imaging. Laparoscopic procedures were per-formed in the form of the determination of the presence of the testis, laparoscopic orchiopexy or laparoscopic orchiectomy. Scrotal examinati-ons of the patients were done again under gene-ral anesthesia. The first trocar was inserted with the method of Hasson. In addition, by placing two more 5 mm-trocar, the process was carried out with a total of 3 trocars.
Results: Findings: The testis could not be palpated right in 4, left in 3 and bilateral in 3 of a total of 10 cases whose ages ranged from 1-14 (mean 5.5) years. The testis in 2 cases who co-uld not be bilaterally palpated, in one case who-se left side was not palpated and in 1 case who-se right side was not palpated was detected as intra-abdominal with the magnetic resonance imaging and the laparoscopic orchiopexy was performed to all of these cases detected as intra-abdominal. The testis which could not be determined with physical examination and imaging techni-ques in all of 6 cases (7 undescended testis) was found to be locali-zed as intra-abdominal in laparoscopy. While the laparoscopic orc-hiectomy was performed to 2 of these cases, the laparoscopic orchi-opexy was performed to 4 cases (5 undescended testis). Intraopera-tive complication was not occurred in any of the cases. Histopatho-logical evaluation of the two cases whom the orchiectomy was per-formed was consistent with the atrophic testis.
Conclusion: Laparoscopy should be preferred as a minimal in-vasive treatment option for the diagnosis and treatment of intra-abdominal testis which cannot be detected with the physical exami-nation and imaging techniques.
Key Words: Undescended testis, laparoscopy, orchiectomy, orchiopexy
Abstract
Objective: The laparoscopic approach was evaluated in the diagnosis and treatment of the cases with non-palpable testis in childhood.
Material and Methods: A total of 10 pati-ents were evaluated between the dates of De-cember 2010 and July 2011. All of the patients were evaluated with detailed history, physi-cal examination, ultrasonography and magne-tic resonance imaging before the surgery. Lapa-roscopic procedure was performed to 10 cases with non-palpable testis, four of whom could be detected with magnetic resonance imaging and six of whom could not be detected with the physical examination and the methods of the imaging. Laparoscopic procedures were per-formed in the form of the determination of the presence of the testis, laparoscopic orchiopexy or laparoscopic orchiectomy. Scrotal examinati-ons of the patients were done again under gene-ral anesthesia. The first trocar was inserted with the method of Hasson. In addition, by placing two more 5 mm-trocar, the process was carried out with a total of 3 trocars.
Results: Findings: The testis could not be palpated right in 4, left in 3 and bilateral in 3 of a total of 10 cases whose ages ranged from 1-14 (mean 5.5) years. The testis in 2 cases who co-uld not be bilaterally palpated, in one case who-se left side was not palpated and in 1 case who-se right side was not palpated was detected as intra-abdominal with the magnetic resonance imaging and the laparoscopic orchiopexy was performed to all of these cases detected as intra-abdominal. The testis which could not be determined with physical examination and imaging techni-ques in all of 6 cases (7 undescended testis) was found to be locali-zed as intra-abdominal in laparoscopy. While the laparoscopic orc-hiectomy was performed to 2 of these cases, the laparoscopic orchi-opexy was performed to 4 cases (5 undescended testis). Intraopera-tive complication was not occurred in any of the cases. Histopatho-logical evaluation of the two cases whom the orchiectomy was per-formed was consistent with the atrophic testis.
Conclusion: Laparoscopy should be preferred as a minimal in-vasive treatment option for the diagnosis and treatment of intra-abdominal testis which cannot be detected with the physical exami-nation and imaging techniques.
Key Words: Undescended testis, laparoscopy, orchiectomy, orchiopexy