Abordaje Laparoscópico en el Testículo no Palpable

objective: to evaluate our experience in laparoscopic management as the procedure of choice for nonpalpable testes (npt). methods: review of charts of all boys with npt who underwent laparoscopy (january 2000 december 2005). demographic data, ultrasound (us) results, surgical details were documented. results: sixty-three patients (74 npt) were identified; 25 left, 26 right and 12 bilateral. mean age at diagnosis was 3.6y (lm-13y). thirty-seven cases had a pre-op us; in 29 (78%) the testis was not found; 7(22%) an intra-canalicular teste was described. all were impalpable at evaluation under anesthesia (eua). mean age at surgery was 4.9y (2 m-17 y). laparoscopic findings were; intra-abdominal teste (n = 24, 33%), vanishing teste (n = 12, 16%) and vas-vessels entering inguinal ring (n = 38, 51%). 16/24 underwent a 2-stage fowler-stephens orchyopexy and 8/24 a laparoscopic-assisted single stage orchypexy. when vas-vessels entered inguinal ring, inguinal exploration was performed; 23 cases underwent orchyopexy; 13 had orchydectomy (atrophic-vanishing). after follow-up, 3 testes are atrophic. conclusions: 36/74 npt were not in the inguinal canal (24 intraabdominal and 12 vanishing). when vas-vessels entered inguinal ring, 13 were vanishing-atrophic and not identifiable (eua or us). hence, in 49 cases (66%) laparoscopic exploration was critical in teste location, therefore this approach may be the procedure of choice for npt.