Page 23 - WJOLS - Laparoscopic Journal

Shahid Ahmed Shaikh

of the patient and the type of operation done by laparoscope and poor, success in this surgery is defined as no testicular
(i.e. single or two stage Stephen and Flower or autotransplant atropy and intrascrotal position (Table 1).
of testicle). We also examined the results of the procedures
performed. We also selected articles where diagnostic > 90% Excellent
laparoscopy was done for undescended testis to see if it is 80-90% Very good
superior to ultrasound, and MRI. We have selected articles 70-80% Good
from various hospitals around the world where operations 60-70% Average
have been done by general surgeon, pediatric surgeon and < 60% Poor
specialist pediatric urologist. This was done to know the And for diagnosis we have mentioned (***) if the
popularity of laparoscopy among different specialist diagnosis was accurate and (**) if diagnosis could not be
surgeons around the world, and also to see if they have made. We have mentioned as (***) for all the cases where
recommended for using laparoscopy for diagnosis and the therapeutic procedure was done as it is logical that
management for impalpable abdominal testis. diagnostic laparoscopy will be done before therapeutic
procedure is carried out.
RESULTS
DISCUSSION
We arbitrarily classified the results of surgery from the All the literature which we have reviewed suggests that
articles we reviewed as excellent, very good, good, average, laparoscopy is the best method for the diagnosis of

Table 1: Results of laparoscopic surgery for impalpable testis
S Author + Diagnostic/ ++ No of Results Comment on use of laparoscopy by the
no. Therapeutic patients author
1. Battaglino F, Pesce C, et al 11 TD 74(86) Excellent*** Author advocates the use of laparoscopy in
all patients with nonpalpable testis
2. Chang B, Palmer, et al 12 TD 80(101) Excellent*** Author states “LO is an effective method for
managing intra-abdominal testis”
3. Argos Rodriguez MD, et al 13 TD 46(53) Excellent*** Author concludes “Laparoscopy is the only
exploratory procedure that is accurate
enough to enable the diagnosis of
nonpalpable testis and allow the surgical
setting to be done in the same setting”
4. Samadi AA, Palmer LS, et al 14 TD 173(203) Excellent*** Author states “LO has become the standard
for diagnosis and treatment”
5. Radmayr C, Oswald J, et al 15 TD 84(108) Excellent*** Author states “The laparoscopic approach
allows not only the diagnosis, but also
therapy regardless of the procedure carried
out for orchiopexy”
6. Bittencourt DG, Mirinda, et al 16 TD 51(75) Very good*** The author concludes “ Videolaparoscopy is
a safe and effective method for diagnosis and
treatment of nonpalpable testis”
7. Leung MW, Choas NS, et al 17 TD 18(18) Excellent*** The author states “LMTV is a safe and
efficient adjunctive step in orchidopexy for
impalpable or redo undescended testes”
8. Corvin S, Sturm W, et al 18 TD 8(8) Excellent *** The author concludes “These results
demonstrate the suitability of laparoscopy for
the treatment of cryptorchidism in the adult
population”
9. Satar N, Bayazit Y, et al 19 TD 13(21) Excellent*** The author concludes “Diagnostic
laparoscopy is very helpful technique in the
diagnosis of impalpable testis especially
when ultrasound and CAT scan are not
informative”
10. Abolyosr A 20 TD 82(87) Excellent*** The author concludes “Although the results
XX for both open and laparoscopic are fairly
comparable. However laparoscopy provides
significantly less morbidity”
Contd...

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