Cryptorchidism

Published on 27/02/2015 by admin

Filed under Pediatrics

Last modified 27/02/2015

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CHAPTER 31 Cryptorchidism

Step 2: Preoperative Considerations

Step 3: Operative Steps

Incision and Technique

In general, the testis will be visible somewhere in the surgical field, or it can be pulled up into the incision by finding the peritoneal covering (tunica vaginalis) or the processus vaginalis (Fig. 31-2). At this point, an effort should be made to encircle the spermatic cord (and hernia sac if one is present) before opening the tunica vaginalis. The gubernacular remnant is divided, taking meticulous care to ensure that there is no long-loop variant of the vas deferens.
If a hernia sac is present, it is carefully separated from the spermatic cord (Fig. 31-3), and a high ligation performed if possible. Absorbable suture is recommended. The ends of the sutures are clamped with a hemostat to allow countertraction on the peritoneal reflection, which allows easier cephalad dissection of the retroperitoneal testicular vessels.
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