Routine laparoscopy for nonpalpable testes?

There are still no accepted criteria for the selection of patients with non palpable testes for laparoscopy versus a primary surgical exploration. We h ere report our experience using routine laparoscopy in such patients. The a im was to determine whether laparoscopy should be the first operative inter vention or follow an inguinal exploration. Included in the study were 61 bo ys with 69 nonpalpable testes. Thirty-three testes were found in the abdome n, and 36 testes were extra-abdominal or nonexistent. If an exploration of the inguinal region had been the initial surgical intervention, six testes would have been found, making laparoscopy unnecessary. On the other hand, i n the search for 63 missing testes, laparoscopy saved the patients from lap arotomy or an extensive inguinal exploration. We conclude that an accurate knowledge of testis, vas, and vessel location gained by laparoscopy facilit ates the selection of an appropriate surgical strategy, saving at least 51% of patients from laparotomy or an extensive inguinal exploration.