Primary Orchiopexy One Stage Procedure

™ Incise retroperitoneum with a minimal 1-cm margin laterally to the testicle and medially alongside the vas deferens.

™ Mobilize peritoneum carefully across spermatic vessels.

™ Leave all vessels around the vas deferens and the peritoneal plane between vas and vessels intact. Try to avoid electrocautery as much as possible.

™ Mobilize the testicle carefully from the psoas fascia towards the inguinal ring.

™ Create new internal ring medially to the epigastric vessels (shortens the overall distance to the scrotal position).

™ Make an incision at the lower pole of the scrotum and provide a dartos pouch. Insert a laparoscopic grasper, guide it through a tunnel to the new inguinal ring, take the mobilized testicle and pull it into the scrotum without forced tension.

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