Staged laparoscopic traction-orchiopexy for intraabdominal testis (Shehata technique): Stretching the limits for preservation of testicular vasculature

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• 作者：Sameh Shehata^a ; ^{drsamehs@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Rafik Shalaby^b ; Maged Ismail^b ; Mohamed Abouheba^a ; Ahmed Elrouby^a
• 关键词：Intra-abdominal testis ; Laparoscopy ; Traction
• 刊名：Journal of Pediatric Surgery
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：51
• 期：2
• 页码：211-215
• 全文大小：810 K

文摘

We present the midterm results of the novel technique of two-stage laparoscopic traction orchiopexy (SLTO) for the high intraabdominal testis (IAT) for elongation of the testicular vessels without division.

Patients and methods

Boys with IAT proven by laparoscopy were selected for the technique between September 2009 and April 2013 in 2 Egyptian pediatric surgery units. Boys < 6 months or > 9 years were excluded. The technique entails fixation of the testis to a point one inch above and medial to the contralateral anterior superior iliac spine for 12 weeks. Subdartos orchiopexy is then done at the second stage. Both stages are laparoscopically assisted.

Results

SLTO was used in 124 boys (140 testis units) with IAT. Mean follow-up period was 16 (range 6–36) months. Scrotal testes were achieved in 105 (84%) of 125 followed cases. Success was correlated with patient age at operation and with distance of IAT from the internal inguinal ring with higher success in younger patients and in testes nearer to internal inguinal ring.

Conclusion

The novel technique of two-stage laparoscopic traction-orchiopexy is useful in IAT not amenable to one-stage laparoscopic-assisted orchiopexy; it resulted in significant elongation of testicular vessels without atrophy. It is a safe and valid alternative to two-stage laparoscopic Fowler–Stephens technique, which entails division of the main testicular vessels.