[Laparoscopic orchidopexy].

Abstract

The authors have experimented in the pig the possibility of endoscopic treatment of cryptorchidism. Sixteen orchidopexy procedures were performed utilizing 12 Large White pigs weighing 10 to 15 kg. The procedure is described herin, including some details of anesthetic induction. The animal is placed in the Trendelenburg position and three trocars are inserted, in a position which corresponds to that of the umbilicus in humans (through which a laparoscope is passed), in the hypogastrium and in the hypochondrium of the corresponding side. The spermatic vessels are dissected all the way up to their origin and the vas deferens up to a short distance from the bladder. Then an incision is made in the inguinal canal, from the epigastric vessels up to the conjoined tendon. Pressure is applied outside until the testis is introduced into the peritoneal cavity where it is released by sectioning the sustenaculum testis. The cord is then pulled and passed in front of the epigastric vessels and taken out through the deep orifice of the inguinal canal. Once it is free in the peritoneum and after the vessels and the vas have been dissected, it is brought to the bottom of the scrotum with the grasping forceps and the aid of the hand outside. Then it is fixed with a suture through the skin. Finally, the incision in the inguinal canal is sutured with atraumatic nylon 0 suture as in the McVay technique for inguinal hernia repair. The procedure has started to be employed in the clinical setting.