Staged laparoscopic-traction orchiopexy versus Fowler–Stephen technique for abdominal testes: A comparative study | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 41, Issue 2, April 2022 PDF (1.08 MB) | ||||
| DOI: 10.4103/ejs.ejs_29_22 | ||||
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| Authors | ||||
| Mohamad Alekrashy; Hesham Kassem; Wael Elshahat | ||||
| Abstract | ||||
| Introduction Undescended testis (UDT) is a frequent disease that affects 3–5% of full-term newborns and more than one-third of preterm babies. Most UDT at different levels of inguinal canal, about 10%, are impalpable and are present in the abdomen. Several techniques have been described for the management of UDT, of which laparoscopic orchiopexy is considered the gold-standard-met staged laparoscopic-traction technique (Shehata approach) that is a two-stage technique based on lengthening testicular vessels, which facilitates repositioning the testis down to scrotum without division of the testicular vessels. Aim The results of stepwise laparoscopic-traction orchiopexy (Shehata method) and Fowler–Stephens laparoscopic orchiopexy (FSLO) in patients with intra-abdominal testes are compared in this research. Patients and methods Between January 2017 and December 2020, we conducted a retrospective cohort study. During this time, 61 patients had laparoscopic exploration, with 51 of them having their testes visualized as intra-abdominal and undergoing laparoscopic orchiopexy. If the testis could be moved to the opposite internal inguinal ring without putting strain on the testicular vasculature, a single-stage vessel-intact orchiopexy (VILO, =10) was done. We used a two-stage approach (=38) since the vessels were discovered to be short and the testis requires mild-to-severe stress to reach the opposite internal ring. Results There was no age difference between the two groups. The first stage operating time was considerably shorter in FSLO (=0.001). The testes were able to reach the lower part of the scrotum in 15 (83.3%) of the FSLO patients, while the testes occupied the upper scrotum in three individuals (16.7%). The testis filled the lower half of the scrotum in 13 (65%) individuals, and the upper part of the scrotum in seven (35%) patients, who had the Shehata approach. There was no testicular atrophy in Shehata technique, while it occurred in two (11.1%) patients in FSLO. Conclusion Staged laparoscopic-traction orchiopexy (Shehata technique) is a safe and effective procedure that could be done when testicular vessels are relatively short that one-stage orchiopexy cannot be applied. | ||||
| Keywords | ||||
| Laparoscopy; Orchidopexy; Shehata technique; staged traction | ||||
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