Omar M Kasem¹, Khalid M Elshimy², Hamed M Seleim² and Mohamed I Elsawaf³

¹MSC of General Surgery, Faculty of Medicine, Tanta University, Egypt
²Assistant Professor of Pediatric Surgery, General Surgery Department, Faculty of Medicine, Tanta University, Egypt
³Professor of Pediatric Surgery, General Surgery Department, Faculty of Medicine, Tanta University, Egypt

*Corresponding Author: Mohamed I Elsawaf, Professor of Pediatric Surgery, General Surgery Department, Faculty of Medicine, Tanta University, Egypt.

Received: February 12, 2024; Published: March 10, 2024

Abstract

Background: Several techniques were recorded in treating intra-abdominal testis including vessel intact laparoscopic orchidopexy (VILO), microsurgical auto-transplantation, one/two stage open/laparoscopic Fowler-Stephens orchidopexy, and staged laparoscopic traction orchidopexy (Shehata technique). Needlescopic surgery is a recent innovation aiming at scarless surgery, providing safty, efficacy in several pediatric laparoscopic procedures as appendectomy, hernia, and cholecystectomy.

Aim of the work: Evaluating safety, feasibility, and efficacy of needlescopic approach for traction-lengthening treatment of intra-abdominal testes.

Patients and methods: This study was carried out in Pediatric Surgery Unit, Tanta University Hospitals, from September 2021 to September 2022, on 53 boys with unilateral impalpable testes. laparoscopic exploration was done for all cases, if testes were intraabdominally, with long testicular vessels decision was taken to do one stage VILO and in case of short vessels needlescopic Shehata technique was then attempted.

Results: Out of 53 testes, 23 testes were vanishing, 5 cases with long vessels enough to undergo one stage VILO, and 25 cases with short testicular vessels underwent Shehata technique using special type of needles. All cases were completed needlescopically, no conversion, nor intra-operative complications were encountered. Three months postoperative follow up showed that testicular size was comparable clinically with normal contralateral one, and it was normal in 24 (96%) while 1 testis was smaller compared to the contralateral side in 4 year old boy and the difference was statistically insignificant (P value was 0.28).

Conclusion:Shehata technique is an excellent option for cases with intra-abdominal testis with short vessels that can gain length by gradual controlled traction, thus can be transposed easily down into the scrotum without tension. Adding needloscopic assistance to shehata technique is a new, and promising technique. Almost non-visible scars were recorded and all parents reported excellent cosmetic results.

Keywords: Impalpable Testis; Staged Traction; Needlescopic Surgery

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Citation

Citation: Mohamed I Elsawaf.,et al. “Needlescopic Traction (Shehata technique) for Impalpable Undescended Testes: New Era".Acta Scientific Paediatrics 7.4 (2024): 13-19.

Copyright

Copyright: © 2024 Mohamed I Elsawaf.,et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.