Minilaparoscopy for abdominal cryptorchidism in children– initial experience

Vasile Dan Stanca, Andrei Boc, Alexandra Poienar, Paul Prundus, Alina Marginean, Ioan Coman,

Pediatric Urology Department, Clinical Municipal Hospital Cluj-Napoca, Romania

Introduction: The diagnostic and terapeutic options for the cryptorchid testicles that are located in the abdominal cavity are limited. The laparoscopic approach is the only mini-invasive method that allows the localization of the testicles and the initiation of treatment.

Objective: Between January 2010 and May 2014 we treated 5 patients aged 1-16 years with unilateral or bilateral abdominal cryptorchidism, with a total of 8 undescented testicles. The diagnostic protocol included clinical examination and diagnostic transperitoneal laparoscopy. The intraabdominal testicle was either removed or placed in the scrotum, the decision being made considering the state of the contralateral testis. Both orchidectomy and orchidopexy were done by laparoscopic approach, continuing the diagnostic procedure.

Results: All 5 patients had non-palpable testicles. One patients had bilateral orhidopexy in one-step Fowler-Stephens procedure. One patient had laparoscopic orhidectomy, one patient had ”vanishing testis” and on 2 patients we perform the first stage of the two-steps Fowler-Stephens procedure. The operative time was 16 minutes for diagnostic laparoscopy, 35 minutes for unilateral laparoscopic orhidectomy, 50 minutes for one step orhidopexy and 40 minutes for the first stage of the two-step orhidopexy. There were no intraoperative or postoperative complications. The average hospitalization was 3 days.

Conclusions: Laparoscopic exploration in cryptorchism is efficient in replacing other diagnostic techniques. It reveals the location of absent testis in the scrotum and allows minimally invasive correction of this pathology.