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Pediatric Surgery International

, Volume 34, Issue 1, pp 97–103 | Cite as

Evaluation of two-staged Fowler–Stephens laparoscopic orchidopexy (FSLO) for intra-abdominal testes (IAT)

  • Deepak Bagga
  • Ashish Prasad
  • Shabnam Bhandari Grover
  • Nidhi Sugandhi
  • Narender Tekchandani
  • Samir Kant Acharya
  • Amat Samie
Original Article
  • 176 Downloads

Abstract

Introduction

The best operative intervention for intrabdominal testis (IAT) has not been standardized as yet. The question of whether to bring down an IAT with a single-staged vessel-intact laparoscopic orchidopexy (VILO) or a two-staged laparoscopic Fowler–Stephens orchidopexy (FSLO) is still undergoing debate, with both the procedures being popular. The present study has been designed to evaluate the factors predicting the success or failure of two-staged FSLO for (IAT).

Methods

43 boys with 49 non-palpable testes underwent diagnostic laparoscopy out of which 35 underwent two-staged FSLO. Size of the testis was measured with a graduated probe in both stages. Independent variables such as age, height, testis-to-internal ring distance (T-IR), neo internal ring-to-midscrotal distance (NIR-MS), and mobility-to-contralateral ring (MCIR) were analysed. Postoperatively 34 IATs were followed up clinically as well as ultrasonologically after 6 months, to see for the size, position, and vascularity. Based on this, the patients were divided into two groups, Group A (successful) and Group B (Failed).

Results

24 IATs had a successful outcome (Group A) and 11 were failure (Group B). The overall success rate of the study was 68.6%. The difference in mean age of patients in both groups was insignificant (p = 0.89) (Fig. 1), and similarly, the difference in mean height was insignificant (p = 0.61). The difference in mean T-IR in both the groups was insignificant (1.85 versus 2.77 cm; p = 0.09) and mean NIR-MS was 5.41 cm in Group A and 5.10 cm in Group B, and the difference again was insignificant (p = 0.23).

Conclusion

The success rate of FSLO was 68.6%. None of the above-described independent variables have any effect on the outcome of two-staged FSLO. While VILO remains the treatment of choice for IAT located at or near the ring, but IAT higher than this, two-staged FSLO gives a better chance for achieving intra-scrotal orchidopexy.

Keywords

Laparoscopic Fowler–Stephens orchidopexy Intra-abdominal testis 

Notes

Compliance with ethical standards

Ethical clearance

Ethical committee (S.no. VMMC/SJH/Ethics/Thesis/SEP-11/24 dated 24/05/2013), Vardhman Mahavir Medical college & Safdarjung Hospital, New Delhi.

Conflict of interest

The authors declares that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Deepak Bagga
    • 1
  • Ashish Prasad
    • 1
  • Shabnam Bhandari Grover
    • 2
  • Nidhi Sugandhi
    • 1
  • Narender Tekchandani
    • 1
  • Samir Kant Acharya
    • 1
  • Amat Samie
    • 1
  1. 1.Department of Paediatric SurgeryVardhman Mahavir Medical College and Safdarjung HospitalNew DelhiIndia
  2. 2.Department of RadiologyVardhman Mahavir Medical College and Safdarjung HospitalNew DelhiIndia

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