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Orchiopexy—Laparoscopic

(Orchidopexy—Laparoscopic)

Pronounced: or-kee-o-pecks-ee

Definition

Orchiopexy is a surgery to lower the testicles into the scrotum. Testicles should move down from the belly into the scrotum before birth. Some boys are born with 1 or both testicles still inside the belly or groin. This is called undescended testicles.

Undescended Testicles

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Reasons for Procedure    TOP

Doing this procedure may help:

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your child's doctor will review possible problems such as:

  • Testicle moves back into the groin
  • Testicular injury
  • Testicular loss
  • Bleeding
  • Infection
  • Injury to nearby structures
  • Anesthesia reaction

What to Expect    TOP

Prior to Procedure

Your child’s doctor may do:

  • A physical exam
  • Blood or urine tests
  • Ultrasound

Talk to the doctor about your child’s medicines. Your child may need to stop them up to 1 week before the procedure.

Bring special toys, books, and other comforts for your child.

Your child will need to stop eating the night before:

  • For children younger than 1 year—they may need to stop after midnight the night before.
  • They may be able to have clear liquids such as breast milk, water, or clear juices, up to 2 hours before the procedure.

Anesthesia

General anesthesia will block pain and keep your child asleep.

Description of the Procedure    TOP

Small keyhole incisions will be made in 1 or both sides of the groin and in the belly. Long, thin tools will be passed through the keyholes. They will allow the doctor to see inside the belly to find and check the testicle.

The testicle is then pulled into a pouch made in the scrotum. Stitches will hold the testicle in place for life. Stitches that dissolve are used on the incisions.

In some cases, a small button is placed on the outside of the scrotum. The button holds the testicle down until the area heals. The doctor removes the button by cutting the stitches.

How Long Will It Take?    TOP

About 1 hour per testicle. In most cases, your child can go home on the same day. If they have problems, they may need to stay longer.

How Much Will It Hurt?    TOP

Anesthesia keeps your child pain free during the procedure. Pain can be eased with medicines after the procedure.

Post-procedure Care    TOP

At the Care Center

The healthcare staff will monitor your child as they wake up.

Preventing Infection

During your child's stay, the healthcare staff will also take steps to lower the chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your child's incisions covered

There are also steps you can take to lower your child's chance of infection such as:

  • Washing both you and your child's hands often, and reminding visitors and healthcare staff to do the same
  • Reminding your child's healthcare staff to wear gloves or masks
  • Not letting others to touch your child's incision

At Home

To help your child get healthier faster:

  • Engage in gentle play. Avoid tiring activities for a few weeks. Your child should avoid sitting on or riding a bicycle or other toys that require straddling for about a week after the surgery.
  • Watch your child for signs of pain. These may include irritability, trouble moving, sweating, or pale skin.

Call Your Child’s Doctor    TOP

Call your child’s doctor if any of these occur:

  • Increasing pressure or pain
  • Redness, pus, puffiness, or tenderness around the incision
  • Changes in frequency, odor, appearance, or volume of urine
  • Difficulty urinating
  • Fever or chills
  • Persistent nausea or vomiting
  • Belly pain
  • Tiredness
  • Loss of hunger

If you think your child has an emergency, call for emergency medical services right away.

RESOURCES:

Family Doctor—American Academy of Family Physicians
https://familydoctor.org
Healthy Children—American Academy of Pediatrics
https://www.healthychildren.org

CANADIAN RESOURCES:

Caring for Kids—Canadian Pediatric Society
https://www.caringforkids.cps.ca

References:

Cryptorchidism. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116422/Cryptorchidism. Updated October 2, 2017. Accessed June 14, 2018.
Elyas R, Guerra LA, Pike J, et al. Is staging beneficial for Fowler-Stephens orchiopexy? A systematic review. J Urol. 2010;183(5):2012-2018.
Orchiopexy. Encyclopedia of Surgery website. Available at:
...(Click grey area to select URL)
Accessed June 14, 2018.
Orchiopexy discharge instructions. Children’s Minnesota website. Available at: https://www.childrensmn.org/educationmaterials/childrensmn/article/15950/orchiopexy-discharge-instructions/. Updated August 2017. Accessed June 14, 2018.
Last reviewed June 2018 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 6/14/2018

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