Infection

■ Respiratory complications

■ Trauma to vas and cord structures

• Accurate in detection of impalpable testis

• Dual-purpose, minimally invasive procedure (diagnosis and therapeutic)

• Avoids laparotomy and therefore decreases morbidity

• Any other imaging technique to locate the testis would require a general anesthetic as well

TABLE 6.3. Possible outcomes during pediatric laparoscopy for UDT

Laparoscopic Finding

Blind ending vas and spermatic vessels above the internal inguinal ring (44%)

Intra-abdominal testis located either adjacent to the internal inguinal ring, in the retroperitoneum or the pelvis (36%)

Vas and spermatic cord seen entering the internal inguinal ring (20%)

Inability to visualize either the testis or the spermatic vessels laparoscopically (<1%)

Comments and Action

Vanishing testis (possibly due to ischemia in fetal life)

^ no further action is required

If atrophic ^ consider laparoscopic orchidectomy

Assess viability for orchidopexy— either open or laparoscopic; one- or two-stage procedure

Testis likely to be in the inguinal canal

^ open exploration of inguinal canal

^ open exploration mandatory

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