Asian journal of endoscopic surgery · 2026
Fertility-Preserving Laparoscopic Spermatic Cord Elongation in Bilateral Intraabdominal Testes: A Case of Fused Spermatic Cords.
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Masuko Takayuki, Yanai Toshihiro
Аннотация
INTRODUCTION: The optimal surgical approach for bilateral intraabdominal testes remains controversial. The Shehata technique has shown promising results as a fertility-preserving method by elongating the gonadal vessels without vessel division.
MATERIALS AND METHODS: We present a case of bilateral intraabdominal testes treated with simultaneous bilateral Shehata technique.
SURGICAL TECHNIQUE: At 9 months of age, bilateral testes were identified laparoscopically. After dissection of the spermatic cords, a one-stage bilateral orchidopexy was attempted. Due to significant tension in the testicular vessels, the testes were crossed and fixed to the contralateral abdominal wall following the Shehata technique. Nine weeks later, the spermatic cords were found to be fused. Adhesions were carefully dissected laparoscopically while preserving both cords, and the testes were successfully fixed in the scrotum.
DISCUSSION: This case highlights the risk of cord adhesion when applying the Shehata technique bilaterally and simultaneously. A staged approach is recommended to prevent this complication.
MATERIALS AND METHODS: We present a case of bilateral intraabdominal testes treated with simultaneous bilateral Shehata technique.
SURGICAL TECHNIQUE: At 9 months of age, bilateral testes were identified laparoscopically. After dissection of the spermatic cords, a one-stage bilateral orchidopexy was attempted. Due to significant tension in the testicular vessels, the testes were crossed and fixed to the contralateral abdominal wall following the Shehata technique. Nine weeks later, the spermatic cords were found to be fused. Adhesions were carefully dissected laparoscopically while preserving both cords, and the testes were successfully fixed in the scrotum.
DISCUSSION: This case highlights the risk of cord adhesion when applying the Shehata technique bilaterally and simultaneously. A staged approach is recommended to prevent this complication.