OUTCOME OF LAPAROSCOPIC-ASSISTED ORCHIDOPEXY IN PEDIATRIC POPULATION

Abstract

Objectives: To determine outcome of laparoscopic assisted orchidopexy in pediatric population with undescended testes. Materials and Methods:  Approval was obtained from CPSP, Karachi, and Saidu Group of Teaching Hospitals, Swat. Eligible children were enrolled after explaining the study, and written informed consent was obtained from parents/guardians. Demographic and clinical data were recorded on a structured proforma. Laparoscopic assisted orchidopexy was performed under general anesthesia with endotracheal intubation and prophylactic intravenous antibiotics. A 5-mm umbilical camera port and two additional ports were used for intra-abdominal testes. Testicular position and mobility were assessed; testes located within 2 cm of the internal inguinal ring underwent one-stage orchidopexy, while those >2 cm underwent two-stage orchidopexy. The testis was mobilized and positioned in a subdartos pouch using the Prentiss maneuver. Surgical success and postoperative complications were documented under the supervision of an experienced pediatric surgeon. Results: The mean age was 5.67±3.16 years, mean weight 19.25±6.20 kg, and mean operative time 71.75±5.39 minutes. Most patients were aged 1–5 years (58.1%), rural residents (51.6%), and had right-sided testes (62.9%). Testes were mainly located near the kidney (48.4%). Overall, surgical success was achieved in 79.0% of patients. Surgical success was significantly associated with residence (p=0.03), but not with age, socioeconomic status, testicular location, laterality, or operative time (p>0.05). Conclusion: It was concluded that Laparoscopic-assisted orchidopexy (LAO) is a safe, effective, and reproducible procedure for pediatric intra-abdominal cryptorchidism, achieving a 79.0% success rate regardless of age, laterality, operative time, financial background, or testicular depth. While early referral remains crucial for optimal long-term testicular function, LAO provides versatile mobilization for high-positioned testes, though prospective multi-center studies with long-term follow-up are needed to assess fertility outcomes.