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during lap exploration for intra abdominal UDT

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  • Admin
    Administrator

    • Sep 2020
    • 6894

    #1

    a_clinical_pearl during lap exploration for intra abdominal UDT

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  • Admin
    Administrator

    • Sep 2020
    • 6894

    #2
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    • Admin
      Administrator

      • Sep 2020
      • 6894

      #3
      Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -

      "If a one-stage procedure is chosen, carefully place cephalad traction on the testis to confirm that the epididymis and vas deferens do not loop into the inguinal canal, so that these are not injured during the following step. Identify and transect the gubernaculum testis to allow complete mobilization."
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      • Admin
        Administrator

        • Sep 2020
        • 6894

        #4
        Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -

        "If the testicle is so high that a Fowler-Stephens procedure seems inevitable, high division of the testicular pedicle before any peritoneal dissection with return to do the orchiopexy in a few months often allows the collaterals the best chance to develop via the artery of the vas and the cremasters."
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        • Admin
          Administrator

          • Sep 2020
          • 6894

          #5
          Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -

          "If the vas deferens ends blindly, with no testicle at its end, the gonad must still be sought by identifying the distal end of the testicular artery, usually very high in the abdomen. This gonad can be simply resected to remove the risk of malignant degeneration in a testicle which will have no spermatogenic function."
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          • Admin
            Administrator

            • Sep 2020
            • 6894

            #6
            Quotes from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -

            "it is imperative to make an early decision on the likelihood of a successful one-stage procedure based on the intra-abdominal location of the testicle at laparoscopy."

            Pediatric surgeons need to determine if treatment should be performed with one- or two-stage Fowler-Stephens orchiopexy at the initial laparoscopic inspection.
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