腹腔镜治疗不可触及型隐睾222例

目的探讨腹腔镜在未触及睾丸的隐睾患儿中的诊治作用。方法对2005年8月-2011年1月在本科诊治的222例未触及睾丸的隐睾患儿行腹腔镜探查(229个睾丸)。年龄12个月～16岁(平均56个月)。术前常规行阴囊腹股沟和盆腔超声检查。术后随访2～72个月(平均32个月)。随访内容包括触诊睾丸位置,判断是否有回缩,超声测量睾丸大小,判断睾丸是否有萎缩。结果经腹腔镜、腹股沟探查及术后病理证实睾丸缺如158个;睾丸残余11个;腹股沟型高位隐睾5个;睾丸位于腹腔55个。其中低位型隐睾20个,高位型隐睾35个。并卵黄管退化不全4例;真两性畸形1例,条索状性腺1例。行常规腹股沟开放手术15个睾丸,腹腔镜辅助下一次性睾丸固定术10个睾丸,Fowler-Stephens(F-S)分期睾丸固定术25个睾丸,F-S一期睾丸固定术8个睾丸,2个发育不良睾丸行腹腔镜下睾丸切除术。卵黄管退化不全者行始基子宫切除,条索状性腺行性腺切除术,两性畸形性腺活检一侧为睾丸,一侧为卵巢。术后随访患侧睾丸萎缩4个,包括行F-S一期睾丸固定术2个睾丸,腹股沟切口睾丸一次固定术1个睾丸,F-S分期固定术1个睾丸;睾丸回缩2个,均为腹股沟切口睾丸一次固定术。结论腹腔镜能够准确诊断未触及睾丸并进行相应治疗。对于腹腔内低位隐睾,腹腔镜辅助下一次性睾丸固定术效果好,明显优于常规手术。腹腔内高位隐睾适合行F-S分期手术。     

小儿非嵌顿性腹股沟斜疝对精索、睾丸影响的临床研究

目的：研究非嵌顿性腹股沟斜疝对精索、睾丸的影响。方法：阴囊外手法测定163例无嵌顿史、单侧腹股沟斜疝患儿睾丸体积,作为对照同时测定131例同年龄段正常儿双侧睾丸体积;患儿组有97例、对照组有82例,同时采用B超阴囊外测定。将采用不同方法测定的患儿睾丸体积分别进行统计学处理;同时将患儿组双侧睾丸体积差和对照组双侧睾丸体积差进行统计学处理。患儿组均手术治疗,术中观察精索静脉,术后3个月、6个月及6－12个月随访测定患睾体积的变化。结果：患儿组双侧睾丸体积有明显差异（P＜0．05）,患侧大于健侧;术后6个月内患睾与健睾仍存在较明显差异（P＜0．05）,术后6－12个月后双侧无明显差异（P＞0．05）。结论：非嵌顿性腹股沟斜疝对精索、睾丸的发育有不良影响,应重新认识腹股沟斜疝及其并发症。     

腹腔镜精索血管高位集束结扎术治疗精索静脉曲张术后睾丸发育评估

目的总结和评估腹腔镜精索血管高位集束结扎术(Palomo术)治疗精索静脉曲张的疗效和术后睾丸发育情况。方法腹腔镜Palomo术治疗31例精索静脉曲张患儿,术前后B超测量患侧曲张静脉的最大直径及两侧睾丸大小,计算睾丸体积,以观察术后静脉恢复情况及术后睾丸体积变化;采用彩色Doppler评估两侧睾丸血液供应,比较术前后睾丸血运。结果腹腔镜Palomo术后1个月精索曲张静脉最大直径较术前明显减小(P<0.01);术后患侧睾丸血液供应无减少;患侧睾丸体积术后增长明显快于健侧(t=2.28 P<0.05),至术后6个月患侧睾丸体积与健侧相仿。结论腹腔镜Palomo术治疗精索静脉曲张安全,简便,患侧睾丸术后有一个补偿性生长过程,无睾丸萎缩和发育不良,手术效果满意。     

腹腔镜在分期Fowler-Stephens睾丸固定术中的应用

目的 探讨腹腔镜在分期Fowler-Stephens睾丸固定术中的应用。方法 应用腹腔镜对13例腹腔内睾丸的隐睾患儿，年龄1岁6个月-10岁，平均4.73岁，行Fowler-Stephens睾丸固定术的Ⅰ期手术，6-12个月后经腹股沟区行Fowler-Stephens睾丸固定术的Ⅱ期手术。结果 13例患儿中，11例已完成Ⅱ期睾丸固定术，经随访3个月-2年，睾丸均位于阴囊内，无睾丸萎缩，另外2例等待进行Ⅱ期Fowler-Stephens睾丸固定术。结论 腹腔镜分期Fowler-Stehens睾丸固定术是一种安全，可靠的手术方法，在治疗腹腔内睾丸的隐睾患儿中成功率明显高于其他手术方法。     

腹腔镜诊治不能触及睾丸的隐睾患儿127例

目的 总结和分析腹腔镜在诊治未触及睾丸的隐睾中的应用.方法 2000年1月-2006年12月应用腹腔镜对127例未触及睾丸的隐睾患儿进行诊治.手术时平均年龄55个月.全麻或加单次硬膜外麻醉下建立气腹,腹腔镜探察.术中发现腹腔内睾丸,行分期Fowler-Stephen手术或睾丸固定术;如精索在腹内为盲端或虽出内环但发育极差,诊断为睾丸缺如,无需进一步探查;如精索发育较好出内环,行腹股沟探查,发现睾丸存在则行睾丸固定术.对分期行Fowler-Stephen手术患儿术后随访睾丸大小和位置.结果 隐睾患儿127例中, 62例 (48.8%)直接诊断为睾丸缺如;24例 (18.9%) 经腹股沟探查后,11例睾丸缺如,13例直接行睾丸固定术;41例(32.3%)诊为腹腔内睾丸,26例行分期Fowler-Stephen手术,包括11例双侧,8例右侧,7例左侧,余15例患儿行睾丸固定术.127例中单侧病例104例(81.9%),其中左侧75例,右侧29例.左侧睾丸缺如57例,占左侧总例数的76%.右侧睾丸缺如12例,约占右侧的41%.双侧病例共23例(18.1%),左右均行分期Fowler-Stephen手术共11例,22只睾丸.双侧睾丸均缺如3例.127例患儿中9只睾丸发育极差,病理均未见曲细精管结构.行分期Fowler-Stephen手术患儿18例得到随访,睾丸大小较术前无缩小,1例术后睾丸上缩.结论 应用腹腔镜可准确诊断未触及睾丸的隐睾,对于腹内靠近内环口的睾丸可行腹腔镜或传统睾丸固定术,对于高位腹内睾丸可行分期Fowler-Stephen手术.     

腹腔镜Palomo手术治疗青少年精索静脉曲张112例

目的探讨腹腔镜下Palomo手术治疗青少年精索静脉曲张的临床疗效。方法总结本院2001年7月至2014年3月,采用腹腔镜Palomo手术治疗,并具有术前、术后3、6、12个月完整B超随访资料的112例精索静脉曲张青少年患儿临床资料。结果共112例患儿,均为左侧,年龄11岁至16岁6个月,中位年龄14岁3个月,年龄≥12岁108例,占96.4%。病史最长3年,平均1.3年。患儿治疗前均行阴囊彩色超声检查确诊,并根据B超测量结果计算睾丸体积。112例中,Ⅱ度25例,Ⅲ度87例,全部在腔镜下完成Palomo手术,手术时间20~35 min,平均27 min。无术后出血、阴囊水肿,平均住院时间5 d。112例均完成术后3、6、12个月随访,并复查B超,无一例复发,发现鞘膜积液6例,附睾囊肿1例。Ⅱ度25例中,术前左右睾丸体积差异在10%~15%者11例(44%);体积差异15%共4例(16%)。Ⅲ度87例,术前左右睾丸体积差异在10%~15%者48例(55.2%);体积差异15%共18例(20.6%)。术后112例中,96例(85.7%)患侧睾丸存在显著的"追赶"生长。术后12个月,Ⅱ度25例中,左右睾丸体积差异在10%~15%者4例(16%),15%共2例(8%);Ⅲ度87例中,左右睾丸体积差异在10%~15%者18例(20.6%),15%者8例(9.1%),手术后睾丸体积差异明显缩小(P0.01)。结论青少年Ⅱ、Ⅲ度精索静脉曲张已经存在两侧睾丸差异性生长,随着临床分度的增加,差异越发显著。Palomo手术后可观察到患侧睾丸显著的"追赶"性生长,左右睾丸体积差异明显缩小。腹腔镜palomo手术具有复发率低,睾丸萎缩可能小等特点,是一种安全可靠的手术方法 。     

儿童获得性隐睾8例临床分析

目的探讨儿童获得性隐睾的临床特点, 总结其诊断及治疗经验。方法回顾性分析杭州美中宜和妇儿医院2020年5月至2021年7月收治的获得性隐睾患儿8例, 年龄为(6.9±2.3)岁;均为单侧患病。收集患儿的一般临床资料, 包括年龄、合并症、既往睾丸检查等资料。本组病例诊断获得性隐睾后均采用手术治疗, 术中观察患侧睾丸的解剖学特点, 术前及术后利用超声测量睾丸的三维直径, 计算睾丸体积、睾丸萎缩指数, 采用t检验比较分析手术前后患侧与健侧睾丸的体积差异。结果本组患儿均合并重度尿道下裂, 在尿道下裂术后临床随诊中发现获得性隐睾, 其中2例为会阴型尿道下裂, 6例为阴茎阴囊型尿道下裂, 1例伴有46, XX性逆转综合征。本组患儿均有尿道下裂术后随访记录和儿童泌尿外科医师的睾丸体检记录, 其中6例曾为正常睾丸, 2例曾为回缩性睾丸。2例对侧睾丸曾因诊断先天性隐睾行睾丸下降固定术。本组患儿术前患侧睾丸体积(0.38±0.19)ml, 健侧睾丸体积(0.65±0.29)ml, 患侧睾丸体积较健侧均有不同程度减小(P<0.05), 睾丸萎缩指数为(41.4±16.6)%。8例患儿诊断后均行睾丸下降...     

腹腔镜分期牵引睾丸固定术(Shehata术)治疗小儿高位隐睾19例并文献复习

目的探讨腹腔镜下分期牵引睾丸固定术(Shehata术)治疗小儿高位隐睾的疗效。方法回顾性分析2018年2月至2022年5月深圳市宝安区妇幼保健院收治的19例一次性手术无法将睾丸无张力下降至阴囊、使用Shehata术治疗的患儿, 患儿年龄范围为1.02～13.50岁, 平均年龄为4.12岁。同时检索Pubmed、Embase、Cochrane、中国知网及万方数据库, 对有关Shehata术的临床研究进行系统复习及分析。结果所有患儿Ⅰ期手术通过彻底的游离精索血管和输精管, 同时将患侧睾丸固定在对侧髂前上棘内上方附近, Ⅱ期手术均发现患侧睾丸血管及输精管较Ⅰ期手术明显增长, 睾丸血管及输精管与腹壁无严重粘连, 睾丸无萎缩, 血运良好, 顺利下降并固定睾丸于阴囊中。术后随访睾丸均固定于阴囊内, 血运良好, 较术前无萎缩。Wilcoxon配对秩和检验分析提示术后睾丸体积大于术前睾丸体积且差异具有统计学意义(P=0.032)。文献检索显示共有4篇文献报道了187例Shehata术治疗小儿高位隐睾的病例, 发生睾丸滑脱有18例(9.62%, 18/187);140例患儿中Ⅱ期术后有20例(14.28...     

小儿精索静脉曲张的腹腔镜治疗及随访

目的探讨腹腔镜在小儿精索静脉曲张中的治疗作用，以及保留或切断睾丸动脉对睾丸功能的影响。方法采用腹腔镜技术对32例患儿行睾丸动、静脉高位结扎术。其中，26例保留睾丸动脉．6例切断睾丸动脉。结果术后1～3个月．29例阴囊内曲张的静脉团块完全消失。术后6个月时．24例患侧睾丸体积增加约20％～30％；15～24个月时，患侧睾丸发育程度与对侧相比，没有明显差异。所有患儿均未发生睾丸萎缩。结论应用腹腔镜技术行睾丸动、静脉结扎切断术，创伤小．并发症少。保留或切断睾丸动脉，对睾丸的发育没有明显影响．但其远期效果需进一步随访。     

儿童异位睾丸13例诊疗体会

目的探讨异位睾丸患儿的诊断和治疗, 提高临床医生对该疾病的认识。方法回顾性分析2014年9月至2019年7月昆明市儿童医院泌尿外科收治的13例异位睾丸患儿临床资料, 从病变类型、病因、临床诊断与治疗方法及预后等方面总结诊治经验。结果 13例异位睾丸患儿年龄6～84个月, 中位年龄19个月;染色体检查结果均为男性。睾丸横过异位4例, 其中2例为腹膜后横过异位, 1例为经腹腔对侧腹股沟横过异位, 1例为经对侧腹股沟下降至对侧阴囊。睾丸同侧异位9例, 左侧5例, 右侧4例, 异位于腹股沟皮下浅筋膜囊内5例、会阴部皮下组织2例、大腿内侧根部2例。对同侧非横过异位睾丸行开放性异位睾丸探查术;对横过异位睾丸行腹腔镜探查术, 术中证实苗勒氏管残留1例。13例患儿术中均探及异位睾丸, 并无张力固定于阴囊内。术后随访6个月至2年, 术后6个月、12个月患侧睾丸体积分别为(239.5±73.2)mm3、(239.0±79.5)mm3, 均较术前的(145.8±51.7)mm3明显增大(P<0.05);而术后6个月与术后12个月相比, B超显示患侧睾丸体积无明显变化(t=0.331, P=0.749)...     

腹腔镜下一期Fowler—Stephens手术治疗大龄儿童腹腔型隐睾

目的总结腹腔镜下一期Fowler—Stephens手术治疗大龄儿童腹腔型隐睾的疗效与经验。方法2005年5月至2011年6月,作者对32例（38侧）大龄儿童腹腔型隐睾实施腹腔镜下一期Fowler—Stephens手术。术中找到睾丸后,在腹腔内高位离断精索血管,游离输精管,保留睾丸固有韧带,将腹腔内睾丸经腹股沟管下降并固定于阴囊内。结果32例（38侧）均一期完成Fowler—Stephens手术,术后随访6个月,所有下降固定的睾丸无回缩、无萎缩,1例复发斜疝。结论腹腔镜下一期Fowler—Ste—phens手术可作为大龄儿童腹腔型隐睾的首选治疗方法。     

Inguinal approach for the management of unilateral non-palpable testis: Is diagnostic laparoscopy necessary?

ObjectiveDuring the last decade laparoscopy has increasingly been advocated as the primary investigative procedure for the management of the non-palpable testis. We reviewed the medical records in a consecutive series of boys with non-palpable testis to examine the contribution of the initial inguinal approach in the management of unilateral non-palpable testis.Materials and methodsAmong the 183 consecutive patients with cryptorchidism from 2003 to 2012, there were 21 patients with unilateral and three with bilateral non-palpable testes. All unilateral patients then underwent inguinal and scrotal exploration through an inguinal incision. For those patients with an intra-abdominal peeping testis, the gonad was placed into the scrotum after meticulous cranial mobilization of the spermatic cord.ResultsPatient age ranged from 11 months to 144 months (mean age: 23 months). Among the 21 unilateral cases, testicular absence or atrophy was confirmed in seven patients with a scrotal nubbin in six, and blind-ending vas and vessels at the external inguinal ring in one patient. Among the remaining 14 patients with sizeable testes, 12 testes were intra-abdominal peeping testes and two testicles were seen within the distal inguinal canal, which may be missed on physical examination owing to patient obesity. The intra-abdominal peeping testicle had the opened processus vaginalis entering the internal ring in which testicle was found. These were fixed into the scrotum successfully by cranial mobilization of spermatic vessel sometimes cutting the internal oblique muscle and by Prentiss and Fowler-Stephen's maneuver. Diagnostic laparoscopy was done on three patients with bilateral cases.ConclusionsGiven the result that most of nubbins are within the scrotum and testes with intra-abdominal peeping testes are fixed down safely into the scrotum, the inguinal approach may suffice for the management of unilateral non-palpable testis. Laparoscopy should be reserved for patients with bilateral non-palpable undescended testes.     

腹腔镜睾丸下降固定术后睾丸萎缩的超声评估

目的 探讨超声检查对腹腔镜睾丸下降固定术后睾丸萎缩的评估价值,尝试建立睾丸萎缩的超声评分方法.方法 分别用腹腔镜行直接睾丸下降固定、Fowler-Stephen Ⅰ或Ⅱ期治疗不可触及隐睾,术后从不同时段对睾丸的体积(无改变、轻微缩小、明显缩小10%以上)、回声(均匀、不均匀)、边界(清晰、模糊、难确定)、实质内微结石(无、散在、弥漫)及血供(清晰、减少、无)等五方面的超声改变来评估睾丸萎缩情况,据此建立相对应超声评估方法,将术后睾丸萎缩进行分级:0级(无萎缩)、Ⅰ级(部分萎缩)、Ⅱ级(完全萎缩).结果 共施行43例(56侧)手术,超声检查能清晰反映睾丸内在情况,术后3～6个月睾丸的超声表现趋于稳定,睾丸萎缩0级42/56(75.0%)、Ⅰ级12/56(21.4%)、Ⅱ级2/56(3.6%).结论 超声检查可在术后3～6个月较为客观地评估腹腔镜睾丸下降固定术后睾丸萎缩情况;本文介绍的超声睾丸萎缩评分方法可应用于临床.     

腹腔镜下高位隐睾Ⅰ期下降固定术的探讨

目的 探讨高位隐睾腹腔镜I期固定术的应用.方法 回顾性研究2005年1月至2008年3月间所收治的35例高位隐睾患儿,年龄1～15岁,平均年龄2.6岁.左侧20例,右侧12例,双侧3例,总计38侧.根据睾丸位置高低,腹腔镜辅助下行精索松解I期睾丸固定或Fowler-Stephens(FS)I期睾丸固定手术.结果 在35例(38侧)患儿中,有33例(34侧)为低位腹腔内隐睾(89.5%),2例4侧(10.5%)为腹腔内高位隐睾.其中的34侧腹腔内低位睾丸及1侧高位睾丸经过松解精索血管或FSI期手术,将睾丸固定于患侧阴囊内;3侧高位睾丸经过松解精索血管I期将睾丸固定于外环口外与阴囊上极之间.手术成功率为92.1%.随访3～24个月(平均6个月),100%睾丸血运好无萎缩.结论 高位隐睾腹腔镜Ⅰ期固定手术效果良好,手术微创.     

Age for testicular torsion?]

Classically, testicular torsion occurs in neonates or during puberty. Between these two ages, is it really an exception? METHOD AND PATIENTS: In order to answer the question, we reviewed the charts of the patients referred to the department of pediatric surgery of Bicêtre hospital between 1992 and 2001. We studied the preoperative examinations, the operative data and the long term evolution. Cases of torsion occurring during neonatal or pubertal periods were excluded. RESULTS: During nine years, 86 patients with "acute scrotum symptoms" underwent surgery. The ages of patients ranged from one month to 11 years (average age: five years) in 26 patients, among which 12 had true testicular torsion. Consultation at the emergency room occurred after one to 72 hours (average of 17). The localization of the pain was on the left in eight cases and on ectopic testicle in two. The testicular volume was increased in 11 cases. Cremasteric reflex was absent in four cases. The doppler flow was normal in four cases and absent in four. During surgery, the testis appearance was considered as normal in six testicles, as necrotized in three (and an orchidectomy was performed) and as ischemic in three. In seven cases, a peroperative contralateral testicle fixation was performed and later one in two. The postoperative course was simple, without infection and with a normal testicular volume in eight cases, increased in one ischemic testis. Testicular atrophy was noted in an ischemic testis, after several months. CONCLUSION: Whatever the age, testicular torsion remains a surgical emergency even with a normal doppler flow.     

Management of the impalpable testis: the role of laparoscopy.

PURPOSE: To evaluate the use of laparoscopy in the management of the impalpable testis. DESIGN: A retrospective analysis of the clinical findings, interventions, and outcome in 87 consecutive boys undergoing laparoscopy for 97 impalpable testes. RESULTS: Fifty seven testes were either absent (n = 35) or present as a small remnant (n = 22), which was removed at contemporaneous groin exploration. There were 27 intra-abdominal testes, including four hypoplastic testes, which were removed laparoscopically. The 13 remaining viable testes were located in the groin. Conventional orchidopexy followed laparoscopy for 21 testes, and was successful in 17 cases. Two stage laparoscopically assisted Fowler Stevens orchidopexies were performed for 13 intra-abdominal testes, with eight satisfactory results. Ultrasound evaluation significantly reduced the number of conventional orchidopexies following laparoscopy. IMPLICATIONS: Laparoscopy is a rational and safe approach for precise localisation of the impalpable testis. Laparoscopically assisted two stage orchidopexy is a successful treatment procedure for intra-abdominal testes.     

Ultrasound examination of paediatric testicles after laparoscopic laser dissection of internal testicular vessels in cryptorchism.

PURPOSE: To evaluate the growth of testicles, their sonographic structure and the recovery of testicular perfusion through collateral vessels after preliminary laparoscopic laser dissection (PLLD) of the internal spermatic artery in cryptorchism. MATERIALS AND METHODS: The postoperative position, the volume increase, the structural and vascular abnormalities and the incidence of epididymal abnormalities were evaluated with ultrasound in 32 children (mean age: 6.5 +/- 1.34 years) after PLLD. The intratesticular blood flow and the flow-in anastomoses from the deferential and cremasteric arteries were assessed using colour and power Doppler US (7.5 MHz transducer). RESULTS: All testicles were permanently positioned in the scrotum and showed growth after surgical treatment. None of the testes showed sonographic signs of atrophy. There were no clear differences in intratesticular perfusion compared to the non-operated testis. A collateral blood flow in the deferential artery was found in 44 cases by colour and/or power Doppler US. A perfusion to the lower testicular pole was detected in 29 cases by power Doppler. Intraoperatively, 12 epididymal inversions were eliminated so that an elongated epididymis was sonographically visualised in three testes. CONCLUSION: Ultrasound can be used for the postoperative control of the testicular structure and the volume increase as well as detection of the flow-in anastomoses. The collateral blood supply after PLLD was sufficient for subsequent growth of testicles in all cases.     

Laparoscopic classification and treatment of the impalpable testis

Laparoscopic orchiopexy has gained popularity in recent years. However, the decision when to perform one-stage laparoscopic orchiopexy without division of the spermatic vessels versus initial ligation of the spermatic vessels followed later by orchiopexy is not clear. A new laparoscopic classification to facilitate decision-making during laparoscopy, according to the position of the impalpable testis and the relation of the spermatic vessels and vas deferens to the internal ring, with a management protocol based on this classification is presented. Over a 2-year period, a total of 37 boys with 52 impalpable gonads underwent a laparoscopic procedure. Four laparoscopic types of testis were noted: type I: no testis visualized; type II: a testis seen at the internal ring with the vas and vessels looping to the internal ring; type III: testis at the internal ring, with vas and vessels going to the testis directly; and type IV: intra-abdominal testis not related to the internal ring. Of the 52 gonads, 19 (36.5%) were type I, 13 (25%) type II, 6 (11.5%) type III, and 14 (27%) type IV. Thirty-three testes were followed up (mean follow-up 8 months); 3 showed atrophy (11%) and 4 were retracted at the scrotal neck after staged, laparoscopic-assisted orchiopexy (LAO). Laparoscopy is of great value for both diagnosis and management of impalpable testes. A classification based on laparoscopic findings will help in planning further surgical action, and LAO is a safe and effective form of operative management for impalpable testes. Accepted: 6 January 1999     

Experience with laparoscopy in nonpalpable testis.

AIM: The aim of this study was to investigate the feasibility and benefits of diagnosis and interventional laparoscopy in those paediatric patients with nonpalpable testes (NPT). PATIENTS AND METHODS: Between 1992 and 1999, 75 patients with NPT (mean age 3 years, range 6 months to 14 years) were treated. 86 testes were evaluated. RESULTS: According to the laparoscopic findings 4 groups of testes were identified: Vanishing testis (n = 32), low abdominal testis (< 2 cm to the internal ring) (n = 26), high abdominal testis (> 2 cm to the internal ring) (n = 24) and intersex patients (n = 4). Of the first group, 19 testes (one bilateral) had blind-ending spermatic cord and vessels and if an atrophic testicular tissue was identified, it was removed laparoscopically. For those with spermatic cord and vessels beyond the internal ring (13 testes), atrophic testes were removed through a high scrotal incision. 19 testes of the second group had a laparoscopy-assisted orchidopexy. In the same group a laparoscopic orchidopexy was performed on 7 testes. 24 testes in the 3rd group had a Fowler-Stephens (FS) stage 1 and 18 testes had a laparotomy performed for FS stage 2 procedure (laparotomy and orchidopexy) after 6 months. At laparotomy there was no evidence of testicular atrophy in all but one testis, which was removed and the FS stage 2 procedure was completed in 17 testes. The follow-up period was between 6 months and 4 years, and two more testicular atrophies were noted after FS stage 2. The results were satisfactory in 15 out of 18 testes (83%). In the intersex group, the patient with testicular feminization underwent laparoscopic orchiectomy. The other patient with bilateral nonpalpable testis was identified as having an uterus and two intraabdominally located gonads on laparoscopy and gonadal biopsies were obtained for diagnosis. Histology demonstrated bilateral ovotestes, confirming the diagnosis of a true hermaphrodite. CONCLUSION: We are of the opinion that laparoscopy decreases the number of laparotomies in NPT, allows a single-stage procedure in low abdominal testis, and facilitates clip ligation of the testicular artery in high abdominal testis. Laparoscopy also provides diagnostic and therapeutic options for vanishing testis and intersex patients.