Sarath Kumar Narayanan1, Jagadeesh N Puthenvariath2, Prathap Somnath2, Arun Mohanan2. 1. Department of Pediatric Surgery, Institute of Maternal and Child Health, Government Medical College, Kozhikode, Kerala, 673008, India. drsharat77@gmail.com. 2. Department of Pediatric Surgery, Institute of Maternal and Child Health, Government Medical College, Kozhikode, Kerala, 673008, India.
Abstract
BACKGROUND: Undescended testis is a common problem, which is prevalent in 3 % of male infants. This study aimed to determine the effect of leaving the deep inguinal ring (DIR) without closure during laparoscopic orchiopexy (LO), with regard to post-operative hernia formation and other outcomes. METHODS: From 2012 to 2014, 63 testicular units were managed with laparoscopy for non-palpable testis (NPT). Diagnostic laparoscopy was performed for all NPTs, and when they were intra-abdominal (42 testicular units), the DIR was left open after mobilization of the testis into the scrotum medial to the inferior epigastric vessels (Prentiss manoeuvre). We followed up these cases to check for hernia formation. RESULTS: The ages ranged from 10 months to 11 years with mean age at 3.7 years. Clinically, no cases presented with hernia, hydrocele or any other complications during a mean follow-up period of 34.4 months. CONCLUSION: Closing the peritoneum over the DIR might be omitted in LO with Prentiss manoeuvre, saving operative time and effort. By doing so, there is no risk of hernia formation.
BACKGROUND: Undescended testis is a common problem, which is prevalent in 3 % of male infants. This study aimed to determine the effect of leaving the deep inguinal ring (DIR) without closure during laparoscopic orchiopexy (LO), with regard to post-operative hernia formation and other outcomes. METHODS: From 2012 to 2014, 63 testicular units were managed with laparoscopy for non-palpable testis (NPT). Diagnostic laparoscopy was performed for all NPTs, and when they were intra-abdominal (42 testicular units), the DIR was left open after mobilization of the testis into the scrotum medial to the inferior epigastric vessels (Prentiss manoeuvre). We followed up these cases to check for hernia formation. RESULTS: The ages ranged from 10 months to 11 years with mean age at 3.7 years. Clinically, no cases presented with hernia, hydrocele or any other complications during a mean follow-up period of 34.4 months. CONCLUSION: Closing the peritoneum over the DIR might be omitted in LO with Prentiss manoeuvre, saving operative time and effort. By doing so, there is no risk of hernia formation.