Laparoscopic Stephen-Fowler stage procedure: appropriate management for high intra-abdominal testes

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Amit AgrawalSandesh Parelkar

Abstract

The length of testicular vessels is the main length-limiting factor to bring down the testes in the scrotum. Fowler and Stephen proposed the division of testicular vessels, high and as far from the testes as possible to maintain collateral blood supply, to treat high intra-abdominal testes. Cortesi introduced the diagnostic laparoscopy and Jorden first did the laparoscopic orchiopexy for nonpalpable testes. We had done Fowler-Stephen staged orchiopexy for high intra-abdominal testes, in which both stages were done laparoscopically. In total, 17 testes of 13 patients had undergone laparoscopic staged Fowler-Stephen orchiopexy. The decision to perform a staged Fowler-Stephen orchiopexy was based on the distance of the testis from the deep inguinal ring on laparoscopy. If distance was more than 2.5 cm, then we proceeded to a laparoscopic staged Fowler-Stephen orchiopexy. In the first stage, testicular vessels were cauterized by bipolar diathermy. Laparoscopic second-stage Fowler-Stephen procedure was done 6 months after the first stage. Patients were regularly followed, and the success of the procedure was assessed by the size of the testes and the position in the scrotum. Testicular vascularity was assessed by color Doppler ultra...Continue Reading

References

Feb 1, 1976·Endoscopy·N CortesiF P Morano
Aug 1, 1989·The Journal of Urology·J A PascualJ Rajfer
Apr 12, 2001·BJU International·B ChangI Franco
Aug 1, 1959·The Australian and New Zealand Journal of Surgery·R FOWLER, F D STEPHENS
Mar 17, 2007·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Stuart A RobertsonGordon A Mackinlay

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Citations

Feb 11, 2015·Pediatric Surgery International·Carolyn WayneUNKNOWN Canadian Association of Paediatric Surgeons Evidence-Based Resource

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