Journal of Developmental Medicine(Electronic Version)  2019, Vol. 7 Issue (4): 259-263 DOI: 10.3969/j.issn.2095-5340.2019.04.005 |
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| Application of laparoscope approaching scrotum via inner ring orifice in transcrotal orchidopexy for treatment of palpable inguinal canalicular cryptorchidism |
| LIU Xue-lai, LI Long, LI Suo-lin, et al
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| 1. Department of Surgery, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China; 2. Department of Pediatric Surgery, the Second Hospital of Hebei Medical University, Hebei, Shijiazhuang 050000, China |
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Abstract 【Abstract】 Objective To introduce a novel laparoscope approaching scrotum via inner ring orifice (LASIRO) technique in laparoscopic assisted transcrotal orchidopexy (LATO) for treatment of palpable inguinal canalicular cryptorchidism, in order to find extracorporally vaginal cavity quickly and precisely. Methods From January 2018 to April 2019, 35 children(37 sides) with palpable inguinal canalicular cryptorchidism who underwent LATO were selected. Before descending testis, LASIRO was used to find and expose tunica vaginalis testis. We reconstructed pneumoperitoneu after opening thecae through scrotal incision. The laparoscopic light was turned down and laparoscope passed patent processus vaginalis (PPV) into affected cavity of tunica vaginalis, and approach into scrotum though scrotal incision and then jack the wall of tunica vaginalis testis out through scrotal incision, followed by opening of tunica vaginalis testis using electronic knife and dragging out of testis in it. Afterwards, transcrotal dissection for orchidopexy was conducted and inner ring orifice was closed by single port laparoscopic percutaneous extracorporeal closure. The clinical outcomes, cryptorchidism position, and complications were followed up. Results A total of 37 sides for palpable inguinal canalicular cryptorchidism were promptly found and exposed tunica vaginalis testis and delivered into the scrotum successfully. The operative time was 25-55 min. There were no intra-operative complications. All of the children were discharged from hospital in two days after operation. Twenty-four children were followed up for 1-16 months without iatrogenic cryptorchidism or testicular atrophy, wound infection, hernia or hydrocele. Conclusions LASIRO is a prompt and precise technique to find and expose tunica vaginalis testis elevating. It is helpful to expose orchis and carry out transcrotal orchidopexy, which is safe, accuracy and cosmetics in practice. The scars are invisible and the peration time is short, in keeping with the concept of the minimally invasive precison and rapid rehahilitation.
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Received: 18 May 2019
Published: 13 November 2019
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