This is an automatically translated article.
The article is professionally consulted by Master, Doctor Vo Thien Ngon - Urologist, Department of General Surgery, Vinmec Da Nang International General Hospital.Currently, there are a number of methods to treat undescended testicles such as hormonal medical treatment or surgical treatment such as open surgery, laparoscopic surgery. Laparoscopy is often used in cases where it is suspected that the testicle is still in the abdomen when the testicle is not palpable.
1. Who is laparoscopic treatment of undescended testicles applied to?
Testicles that have not descended into the scrotum, also known as undescended testicles, undescended testicles are abnormal conditions during the movement of the testicles from the abdomen to the scrotum. When a child is diagnosed with an undescended testicle, there will be 2 cases where the testicle may be still in the abdomen or in the inguinal canal. If on examination, the doctor feels the testicle is located in the groin, he will perform an open surgery. If the testicle is not palpable, a laparoscopy should be performed to find and bring the testicle into the scrotum.2. When is laparoscopic surgery for undescended testicle performed?
Laparoscopic surgery for undescended testicles should be performed as soon as possible after detecting the disease to avoid damage to the testicles. Thanks to the special structure, the scrotum is always kept at a temperature 1 degree Celsius lower than the body temperature. If the testicles have not yet descended into the scrotum, they will have to be in a high temperature environment, which is not favorable for the development of the testicles. and adversely affect the ability to produce sperm
The best time for surgery is 6-12 months because after 1 year of age in the undescended testicle will appear abnormal Leydig cells, reduce the number of germ cells and appear fibrosis around the seminiferous tubules. These will affect fertility later in life.
3. How to conduct laparoscopic surgery to treat undescended testicles
Tinh hoàn ẩn
Observe and evaluate the abdominal organs to find and determine the presence or absence of testicles, the position of the testicles and the size of the testicles. Also evaluate whether the inguinal hole is closed or still open. Remove the suspensory cord as far as possible from the testicle and release the testicle from the abdominal wall. Release the vas deferens and maxillary vas deferens from the abdominal wall. Tunneling for the testicle to descend into the scrotum Opens the scrotum muscle to create a cavity and pull the testicle out of the abdomen to descend into the scrotum. Check the abdomen, clean the abdomen and stop bleeding.
4. Advantages of laparoscopic surgery for undescended testicles
The rate of successful testicular reduction is higher than that of open surgery due to maximum mobility of the testicular vessels and vas deferens. Aesthetic and less painful than open surgery Fast recovery time, patients can quickly be discharged and return to daily activities. Currently, the technique of scrotal anesthesia is one of the techniques used to treat undescended testicles at Vinmec Danang Hospital.
This is a regional anesthetic technique that is performed by introducing local anesthetic into the epidural space through the sacral cleft and sacral canal. Helps relieve pain during and after surgery for almost all surgical interventions on the lower abdomen and lower extremities such as: Surgery of undescended testicle, inguinal hernia, hydrocele in children. Therefore, sacral anesthesia is also known as transsacral epidural.
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