Laparoscopic versus Conventional Open Surgery Approach of Tunica Vaginalis for Palpable Cryptorchidism

Abstract

Objective: To evaluate the advantages of the laparoscopic approach of tunica vaginalis in the treatment of palpable cryptorchidism. Study Design: Randomised clinical comparative study. Place and Duration of Study: Department of Urology Surgery, Baoding Children's Hospital, Baoding, Hebei, China, from July 2019 to June 2020. Methodology: A total of 80 children admitted with palpable cryptorchidism were selected and randomly divided into two groups i.e. the experimental group and the control group, with 40 cases in each group. The experimental group were treated with a laparoscopic approach of tunica vaginalis, and the control group were treated with conventional open surgery. The perioperative indicators, proportion with testicular external fixation, surgical effect, testicular development (6 months postoperative), and incidence of complications were compared. Results: The postoperative ambulation and discharge time of the experimental group were significantly shorter than the control group (p<0.001). The external fixation rate of the control group was higher than the experimental group (p=0.02). The effective rate of the experimental group was significantly higher than the control group (p=0.03). The re-examination performed, 6 months postoperatively, showed that the testicular volume in the experimental group was significantly higher than in the control group (p=0.03). The incidence of the surgical complications in the experimental group was significantly lower than in the control group (p=0.04). Conclusion: Laparoscopic approach of tunica vaginalis is effective in the treatment of palpable cryptorchidism and more conducive to testicular development. It has the advantages of less injury, less complications, quick postoperative recovery, more adequate spermatic cord dissociation, and well-preserved testicular blood supply.