170 / 330
170
28
TH
CONGRESS OF THE ESPU
S15-15 (P without presentation)
LAPAROSCOPIC APPROACH FOR FAILED OPEN
ORCHIOPEXY:TECHNIQUE AND LONG TERM FOLLOW UP
Mario RIQUELME-HERAS
Christus Muguerza, Pediatric Urology, Monterrey, MEXICO
PURPOSE
About 0.2-10% of patients with prior orchiopexy will require reoperation for recurrent cryptorchid-
ism. The most common approach for these patients has been an open inguinal repeat orchiopexy.
The aim of this report is to show the technique,and results in long term follow up, with the totally
laparoscopic approach for failed prior open orchiopexy.
MATERIAL AND METHODS
Fourteen patients with 18 recurrent undescended testes were treated by the totally laparoscopic
orchiopexy approach. We used a four-port technique: one 5 mm umbilical port for a 45 degrees
lent, two 3 mm port and one 10 mm trans-scrotal port, starting with laparoscopic dissection of the
vas deferens and spermatic vessels as high as possible in order to get adequate length of these
structures. The inguinal internal ring was opened and the inferior epigastric vessels are cut in order
to expand the ring. In the vast mayority of the cases the testicule is found 1 cm back of the ring. The
testis was dissected to finally bring it into the abdominal cavity. A transcrotal trocar was introduced
all the way to the abdominal cavity to finally pull through the testis into the scrotum. we fix it with
prolene 5 0 to the scrotum.
RESULTS
Laparoscopic orchiopexy was performed satisfactorily in all but 2 cases in a mean time of 90 min-
utes. We did not experience any perioperative complications. In a mean follow-up of 48 months
there has not been any recurrent cryptorchidism or atrophic testis.
CONCLUSIONS
Laparoscopy offers the advantage of achieving an extensive mobilization of spermatic vessels and
a careful dissection of the vas deferens. This technique is reproducible for surgeons with skills
in abdominal laparoscopy The totally laparoscopic approach for a failed orchiopexy represents
a feasible, safe, and successful procedure.
S15-16 (P without presentation)
PERIOPERATIVE COMPLICATIONS OF PEDIATRIC
UROLOGICAL LAPAROSCOPY: RISK FACTORS
AND PATTERNS
Manuela HUNZIKER
1
, Maya HORST
1
, Daniel WEBER
2
and Rita GOBET
2
1) University Children’s Hospital, Zurich, SWITZERLAND - 2) University Children’s Hospital, Zurich, SWITZERLAND
PURPOSE
Laparoscopic surgery has become the gold standard for the surgical management of upper urinary
tract problems in children. However, there is limited data on the incidence and patterns of complica-
tions in pediatric urology. The aim of our study was to evaluate the risk factors for perioperative
complications in children undergoing laparoscopic urological procedures.
MATERIAL AND METHODS
We prospectively collected intra- and postoperative complications of all conventional and robot
assisted laparoscopic urological procedures performed at our institution between January 2013 and
May 2016. Complications were graded based on Clavien’s classification.