Journal of Developmental Medicine(Electronic Version)  2022, Vol. 10 Issue (3): 215-219 DOI: 10.3969/j.issn.2095-5340.2022.03.009 |
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| Morphology observation of inner ring orifice after laparoscopic assisted transcrotal orchidopexy for treatment of inguinal cryptorchidism combined with indirect inguinal hernia |
| Liu Xuelai, Wang Wenbo, Li Long,et al
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1. Department of Surgery, Capital Institute of PediatricsAffiliated Children Hospital, Beijing 100020, China; 2. Department of Pediatric Surgery, the Second Hospitalof Hebei Medical University, Hebei, Shijiazhuang 050000, China
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Abstract 【Abstract】 Objective To observe morphology of inner ring orifice after conventional three-port
laparoscope orchidopexy and laparoscopic assisted transcrotal orchidopexy (LATO) for treatment of inguinal cryptorchidism combined with indirect inguinal hernia. Method Twenty-four children with inguinal cryptorchidism combined with indirect inguinal hernia underwent conventional three–port laparoscope orchidopexy procedures between May and December 2015 were selected as conventional laparoscope group, and LATO + laparoscopic percutaneous extraperitoneal closure (LPEC) procedures in 22 children with palpable inguinal canalicular cryptorchidism combined with indirect inguinal hernia from November 2016 to April 2017 were selected as LATO group. Vedios were preserved for observation and comparison of inner ring orifice between the two groups. Result In conventional laparoscope group, circular laceration could be noted around inner ring orifice, retroperitoneal wound and slight hemorrhage caused by small vessel rupture could be seen due to peritoneal contraction. Furthermore, spontaneous hemostasis and leakage of extraperitoneal space around inner ring orifice could be found. While for the LATO group, inner ring orifice tissue presented smooth without any destroy around peritoneum, and no hemorrhage could be seen round inner ring orifice and extraperitoneal space. Spermatic cord would migrate interiorly due to pulling during orchidopexy and inner ring orifice was lessened in both procedures group. Morphology changed after orchidopexy but inner ring orifice in both procedures group still exist. Conclusion Compared with conventional three–port laparoscope orchidopexy procedures, LATO procedure does not possess the morphological basis for peritoneal repair, regeneration around inner ring orifice, and potential closure caused by tissue proliferation and remodeling. As the result, the inner ring orifice is still open, and has potential to develop indirect inguinal hernia or hydrocele. Although this, the investigations are still needed to prevent the indirect inguinal hernia or hydrocele caused by the obstruction of spermatic cord.
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Received: 16 December 2020
Published: 31 May 2022
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