Pediatric Laparoscopy for Nonpalpable Testes with New Miniaturized Instruments

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Abstract
New miniaturized pediatric telescopes (1.9 or 3.5 mm) and reusable instruments (3.5-mm trocars, scissors, graspers) were used for the first time in a prospective study to evaluate handling safety and efficacy in laparoscopic diagnosis of unilateral nonpalpable testes. The results were confirmed during the same anesthesia by open operation for either orchiopexy or removal of rudimentary spermatic cord structures. Laparoscopy in 13 boys revealed one abdominal testis, 5 vanishing testes, and 7 cases of inguinal retention associated with an open inner inguinal ring. The illumination and detail resolution of the minitelescope were excellent. The 3.5-mm instruments were fully functioning with regard to tissue dissection. No complications occurred. Without technical disadvantages but with increased safety for the patient, the new miniaturized pediatric laparocopic instruments indeed realize a step forward to minimal invasion in infants and children.