THE ROLE OF LAPAROSCOPY IN EVALUATION OF THE IMPALPABLE UNDESCENDED TESTIS

Background: The evaluation and management of the impalpable testis rem ains controversial. The authors' experience with laparoscopy for the t reatment of this condition is reported here. Methods: All children wit h impalpable testes underwent an examination under anaesthetic and if negative, a laparoscopy was performed to locate the testis. A prospect ive evaluation was undertaken to determine the success and morbidity o f this approach. Results: Thirty-six children (median age 2.5 years) u nderwent 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 norm al-looking testis was brought down. In four patients with bilateral im palpable testes, one testis was absent, three testes were intra-abdomi nal and four were small testis remnants in the groin. The average lapa roscopy 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. Conclusi on: Laparoscopy is safe and effective at localizing impalpable testes in children and can be performed as hay-stay procedures in the majorit y of cases.