Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
J Pediatr Surg. 2012 Dec;47(12):2298-301. doi: 10.1016/j.jpedsurg.2012.09.025.
The aim of this study was to evaluate the feasibility of multi-incisional transumbilical laparoscopic surgery for the management of nonpalpable undescended testes.
A series of 126 patients with 162 nonpalpable undescended testes underwent transumbilical laparoscopic surgery. Their mean age was 1.8 years (range, 1.1-6.5 years). Of the 126 cases, 73 were left-sided, 17 were right-sided, and 36 had bilateral cryptorchidism. Primary orchidopexy and the Fowler-Stephens procedure were used to mobilize the testes.
All the operations were successfully performed without intraoperative complications. No additional ports or any conversions to an open procedure were required. Of the 162 nonpalpable undescended testes, 21 were absent or atrophied. One-hundred thirteen testes underwent primary orchidopexy, and 28 cases underwent a Fowler-Stephens orchidopexy. Patients were followed-up for 6-15 months. Only one case of testicular retraction was observed, and all others maintained a good size and the correct position. The scars were hidden within the umbilicus.
Transumbilical laparoscopic surgery is safe and feasible for nonpalpable undescended testes, and leaves no obvious abdominal or inguinal scar.
本研究旨在评估经脐多切口腹腔镜手术治疗不可触及未降睾丸的可行性。
对 126 例 162 例不可触及未降睾丸的患者进行了经脐腹腔镜手术。他们的平均年龄为 1.8 岁（范围 1.1-6.5 岁）。126 例中，左侧 73 例，右侧 17 例，双侧隐睾 36 例。采用经脐腹腔镜手术对睾丸进行了游离和固定。
所有手术均顺利完成，无术中并发症。无需额外切口或任何转为开放手术。在 162 例不可触及未降睾丸中，21 例睾丸缺失或萎缩。113 例睾丸行一期睾丸固定术，28 例行 Fowler-Stephens 睾丸固定术。患者随访 6-15 个月。仅观察到 1 例睾丸回缩，其余睾丸均保持良好大小和正确位置。切口瘢痕隐匿于脐部。
经脐腹腔镜手术治疗不可触及未降睾丸安全可行，且腹部和腹股沟无明显瘢痕。
