Orchidopexy Unilateral Laparoscopic

Unilateral laparoscopic orchidopexy Surgery

Unilateral laparoscopic orchidopexy is a one-sided minimally invasive procedure in which an undescended testicle (cryptorchidism) is brought down. It conducts the testis into the scrotum and then fixes it, reconstructing the anatomy and reducing the chance of health problems in the future. 

Indication

• Unilateral undescended testis (UDT) - in case of just a testicle not descending into the scrotum.
• Indicated where the testis had not descended at the age of 6-12 months.
• It may also be employed for nonpalpable testis (when testis cannot be palpated at physical examination). 

Laparoscopic Orchidopexy benefits

• The same small cuts and few scars.
• Improved imaging of locating testes within the abdomen.
• Quicker healing and reduced after surgery pain.
• Reduced chances of testicular retraction in relation to open surgery.

Unilateral Laparoscopic orchidopexy procedure

Unilateral laparoscopic orchidopexy is a minimal- access surgery done to mobilise the testis in the inguinal canal and bring it down to the scrotum in cases of unilateral cryptorchidism and for a ball and socket method of detecting the testis. The procedure is usually performed in infants and toddlers if a testis remains undescended at 6-12 months of age. 

Step-by-Step Procedure:

Preparation and Anaesthesia

• General anaesthesia is provided to the patient to provide total comfort and immobility in the operation.
• The area of the lower abdomen and the genitals are washed and sterilized.
• The insertion of a urinary catheter is temporary to empty the bladder.

The Placement of Ports and Laparoscopic Access

• A small cut (5-10 mm) is made by the surgeon near the umbilicus (belly button). 
• The laparoscope (a thin tube with a light and camera) is inserted into the abdominal cavity. 
• Surgical instruments can be positioned in two or three other small ports.
• Carbon dioxide gas (CO2) is introduced into the abdominal cavity to provide working space.

Diagnosis of the Undescended Testis

• The surgeon finds the non-palpable or undescended testis - normally in the location of internal inguinal ring or in the abdomen.
• Spermatic cord, testicular vessels and vas deferens are identified carefully.

Mobilization of the Testis

• The testicular vessels and vas deferens are detached with soft tissues to acquire a sufficient length.
• All peritoneal attachments or adhesions are separated in order to permit the free mobility of the testis.
• To avoid testicular atrophy, the supply of blood is kept in an impeccable manner.

Creation of the Scrotal Pouch

• A small opening is made in the scrotum on the same side as the undescended testicle. 
• The laparoscopic tool creates a tunnel (stract) between the scrotum and the abdomen. 

Testicular Descent and Fixation (Orchidopexy)

• The testis is pulled softly down through the tunnel into the scrotal pouch.
• Then it is fastened (sewn) to avoid retraction by the use of absorbable sutures.
• The testis is located in the scrotum in a natural position.

Inspection and Closure

• The surgeon inspects the patient’s abdomen to make sure there is no bleeding or torsion of the spermatic cord. 
• The gas of carbon dioxide is eliminated, and the removal of all of the instruments is performed.
• Absorbable sutures or skin glue are used to close small cuts and are covered with sterile dressing.

Duration

• The whole process takes 45 to 90 minutes depending on the localisation and complexity of the testis.

Postoperative Care

• The patient is followed on a couple of hours or even in the night.
• Pain reliever drugs are administered as required.
• The usual recovery in normal activities takes place within 7-10 days.
• A follow up check is performed to ensure that there is adequate testicular position and repair.

Recovery after Unilateral laparoscopic orchidopexy

The post-operative recovery of unilateral laparoscopic orchidopexy is normally smooth and quicker as compared to the open surgery; this is because it is less invasive. The following will be an overview of the expectations after the procedure.

Hospital Stay

• Most of the patients (children especially) can be discharged either on the same day or after a day of observation. 
• The most common signs of being discharged are that the patient is awake and is drinking fluids and his vital signs are stable. 

Postoperative Period (The first 24 to 48 hours) 

• During the first two days after surgery, patients are most vulnerable to complications. 
• Mild to moderate or intermittent lower abdominal pain or cramping, or scrotal discomfort or pain that is treated with oral analgesics is expected.
• The areas of incision can be painful; tiny dressings are left dry and untouched.
• The CO2 gas that is employed during laparoscopy may cause minor bloating to the child- this will decrease in 1-2 days.
• Light diet is initiated in a few hours after surgery.

Wound Care

• Maintain the surgical site.

• Removal of dressing normally occurs after 2-3 days or as recommended.
• No bathing or swimming during a 5-7 day period unless authorized by the surgeon.
• Do not put creams or powders on the areas of incision.

Activity Restrictions

• The vast majority of children/adults are able to resume normal daily activity in 7-10 days.
• There should be avoidance of intensive exercise, cycling or contact sports in 3-4 weeks.
• Tight underwear should be avoided; loose cotton clothes should be worn.
• Several weeks should be passed without lifting heavy things and excessive strains.

Pain and Swelling

• Mild swelling of the scrotum or bruising of the scrotum and it heals by itself.
• Cold compress (used cautiously) can be used to swell down.
• Suffering is not severe and can be easily managed with medication.

Follow-up Visits

• Early follow up is usually performed after 7-10 days to assess wound healing.
• Follow-ups (1-3 months later) are needed to ensure the testis is well positioned and is growing normally. 
• An ultrasound can be ordered to ensure blood circulation and viability.

Long-Term Recovery

• It requires approximately 3-4 weeks of full internal healing.
• The majority of children revert to normal physical activity.
• Testis that have been moved tend to be in their usual scrotal position when fixed appropriately.

Best hospital for laparoscopic orchidopexy

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Unilateral Laparoscopic orchidopexy success rate

Unilateral laparoscopic orchidopexy currently boasts a huge success rate and is believed to be one of the most trustworthy operations to be performed in the treatment of unilateral undescended testis (UDT). The least invasive method enables accurate visualization and manipulation of the testicular structures thus yielding improved results than the open surgery.

Overall Success Rate

• In the majority of medical centers, the success rate is 95 to 98 percent.

Conclusion

Laparoscopic unilateral orchidopexy is a safe, effective, and minimally invasive operation that is performed to repair an undescended testis on one side. It provides good visualization, good control of testicular anatomy and minimal scarring in relation to open operation. It has a success rate of 95-98 in the event that the procedure is carried out by an experienced surgeon at the most ideal age (6-18 months old) and the testicles are placed at the correct position, have the ability to grow and function properly. Preventative correction also aids in enhancing fertility potential and the risk of malignancy in the future.

Affordable laparoscopic orchidopexy India GetWellGo

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for unilateral laparoscopic orchidopexy treatment.
• Expert urosurgeon with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food

FAQ

1. Will there be scars?

• There are no large scars — just tiny incision points that slowly get lighter over time, because the laparoscopic technique involves making small entry holes.

2. Can adults have this surgery?

• Yes, in adults with undescended testis, laparoscopic orchidopexy can be performed. But fertility advantages may be minimal, and the surgery mainly reduces cancer risk and permits easier examination.

3. Will this affect fertility and puberty?

• It's been designed to keep your child fertile into the future and allow normal puberty if the surgery is performed at the advised age.

4. What if you wait to have surgery?

• Late surgery (2 y) may be followed by an increased risk of infertility, testicular damage, and testicular cancer in the adult life.a