THE ROLE OF LAPAROSCOPY IN EVALUATION OF THE IMPALPABLE UNDESCENDED TESTIS

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Abstract
Background: The evaluation and management of the impalpable testis remains controversial. The authors' experience with laparoscopy for the treatment of this condition is reported here. Methods: All children with impalpable testes underwent an examination under anaesthetic and if negative, a laparoscopy was performed to locate the testis. A prospective evaluation was undertaken to determine the success and morbidity of this approach. Results: Thirty‐six children (median age 2.5 years) underwent laparoscopy to localize 40 impalpable testes. In 32 patients with unilateral impalpable testis, 10 were intra‐abdominal, nine were absent. In 13 patients, the vas and vessels entered the groin, and in 12 of these a small testis remnant was excised and in the other a normal‐looking testis was brought down. In four patients with bilateral impalpable testes, one testis was absent, three testes were intra‐abdominal and four were small testis remnants in the groin. The average laparoscopy time was 15 min, and 34 of 36 children were operated on as day‐stay cases. One child had an omental hernia via a port site. Conclusion: Laparoscopy is safe and effective at localizing impalpable testes in children and can be performed as day‐stay procedures in the majority of cases.