Orchidopexy (Cryptorchidism)

hode_15a_n.jpg to hode_15d_n.jpg: The drawings and the operative findings will explain and illustrate the main principles of orchidopexy. hode_15a_n.jpg: Following inguinotomy the inguinal channel is opened, and the prefascially or canalicularly encountered testis and spermatic cord mobilized up to the internal inguinal ring, or even higher. Following the longitudinal incision of the skin and the tunica dartos over the finger introduced from the inguinal incision into scrotum, a subcutaneous pouch is formed. hode_15b_n.jpg: The testis is pulled through the scrotal incision downwards and laid down ouside the wound. Following diminution of the incision of the tunica dartos by some sutures the testis is transferred into the earlier formed subcutaneous pouch. If the spermatic cord is too short it can be directed behind and medially to the epigastric vessels; a ligature of these vessels as shown in the drawing is usually unnecessary. hode_15c_n.jpg: The requirement that there is no recurrence after orchidopexy is a sufficient mobilization of the spermatic cord ($$hode_6??££see picture for comparison of the intraabdominal site of the spermatic cord§§ ). After division of the fibers of the cremasteric muscle an additional retroperitoneal mobilization of the spermatic cord is performed. Afterwards, the testis can be laid down in the scrotal pouch without tension. In the case report the mobilized testis and spermatic cord is laid down prior to transfer on the scrotal pouch of the corresponding scrotum to show that its length is sufficient. hode_15d_n.jpg: In this infant with cryptorchidism and inguinal hernia of the left side the vessels of the spermatic cord have been mobilized retroperitoneally up to the lower pole of the kidney; therefore, it was possible to transfer the testis into the scrotum without tension. Notice the residual, relatively long distance of the spermatic cord in front of the incision of the tunica dartos marked with a forceps.