Endoscopic treatment of inguinal cryptorchism

OBJECTIVE: A new endoscopic approach for the treatment of the testicle located in the inguinal canal is described. METHOD: Three trocars are inserted in the umbilicus and both flanks, then the spermatic vessels and vas deferens are dissected. A 2 cm skin incision is performed at the level of the internal inguinal ring and a finger is introduced. An incision is made endoscopically in the inguinal canal between the epigastric vessels and the conjoined tendon. With the finger the testicle is located and partially dissected. Pressure is applied on it until it is introduced into the peritoneal cavity through this incision, where it is released by dividing the sustentaculum testis. The cord is then pulled, the testicle is passed in front of the epigastric vessels and taken through the internal ring. Once the testicle is free in the peritoneum, it is brought into the scrotum. Finally, the inguinal canal is closed endoscopically. CONCLUSIONS: So far endoscopic orchiopexy has only been performed in intraabdominal testicles, and we believe that this procedure can extend the indications of endoscopic treatment for the undescended testis.