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Laparoscopic orchidopexy
LAPAROSCOPIC STEVEN DOCIMO,
ORCHIDOPEXY
M.D., ROBERT G. MOORE, M.D., AND LOUIS R. KAVOUSSI, M.D.
A
4-year-old boy presented with a nonpalpable right testicle. Laparoscopic evaluation (Fig. 1) revealed an intra-abdominal testis. Laparoscopic orchidopexy was undertaken and the testicle was delivered through a neohiatus medial to the medial umbilical ligament. When the testicle was delivered into the scrotum, it appeared viable and in proper orientation. A laparoscopic view (Fig. 2) revealed that the cord was twisted (cord: dark arrows; vas deferens: open arrows). This was corrected by turning the testis 360” in the scrotum. Final view (Fig. 3) demonstrated the straight course of the spermatic vessel and vas. This demonstrates the importance of intra-abdominal inspection of the
cord structure after delivering a testicle during laparoscopic orchidopexy, in order to avoid iatrogenic testicular torsion.
FIGURE 2.
FIGURE 1.
From the Brady Urological Institute, TheJohns Hopkins Medical Center, Baltimore, Maryland Reprint requests: Louis R. Kavoussi, M.D., Brady Urological Institute, The Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224 Submitted: April 25, 1995, accepted: April 25, 1995
FIGURE 3.
EDITOR’S NOTE: “Images in Clinical Urology” is a new feature for UROLOCY. We are currently seeking from urologists original, unpublished, high-quality color or black and white photographs of typical images, accompanied by brief descriptive legends. These images will be subject to the same peer-review process us are original manuscripts. Each image will credit the name of the person who submitted it. (See the Informationfor Contributors sectionfor details.) uR0L0GY~
46 (51, 1995
715
ORCHIDOPEXY
M.D., ROBERT G. MOORE, M.D., AND LOUIS R. KAVOUSSI, M.D.
A
4-year-old boy presented with a nonpalpable right testicle. Laparoscopic evaluation (Fig. 1) revealed an intra-abdominal testis. Laparoscopic orchidopexy was undertaken and the testicle was delivered through a neohiatus medial to the medial umbilical ligament. When the testicle was delivered into the scrotum, it appeared viable and in proper orientation. A laparoscopic view (Fig. 2) revealed that the cord was twisted (cord: dark arrows; vas deferens: open arrows). This was corrected by turning the testis 360” in the scrotum. Final view (Fig. 3) demonstrated the straight course of the spermatic vessel and vas. This demonstrates the importance of intra-abdominal inspection of the
cord structure after delivering a testicle during laparoscopic orchidopexy, in order to avoid iatrogenic testicular torsion.
FIGURE 2.
FIGURE 1.
From the Brady Urological Institute, TheJohns Hopkins Medical Center, Baltimore, Maryland Reprint requests: Louis R. Kavoussi, M.D., Brady Urological Institute, The Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224 Submitted: April 25, 1995, accepted: April 25, 1995
FIGURE 3.
EDITOR’S NOTE: “Images in Clinical Urology” is a new feature for UROLOCY. We are currently seeking from urologists original, unpublished, high-quality color or black and white photographs of typical images, accompanied by brief descriptive legends. These images will be subject to the same peer-review process us are original manuscripts. Each image will credit the name of the person who submitted it. (See the Informationfor Contributors sectionfor details.) uR0L0GY~
46 (51, 1995
715