Both the testis should have descended into scrotum from inside the abdomen before the child is born. Sometimes, however this descend is arrested. The undescended testis can be within the abdomen or outside. If it is inside the abdomen, Laparoscopy is far superior to any other method in locating as well as bringing the testis down. The procedure is done preferably at about 1 year of age.
By key hole surgery, not only can the testis be located precisely, (this is not accurately possible even by the most advanced scans) it can also be brought down into the scrotum by 4 small key holes. The child will be almost pain free on the day after surgery, and can go home usually by the 2nd post operative day.
This is thus a far superior technique when compared to open surgery, were a large wound on the abdomen is required for achieving the same thing. Besides during laparoscopy, there is a 10 to 15 times magnification of all the delicate structures, making laparoscopy more precise and hence more successful than open technique.
Occasionally the testis is not well developed, and therefore should be removed.
Pre-Operative Check Up
- Before admission, the child will be assessed for medical fitness for anaesthesia, by me, the Anaesthetist and the paediatrician.
- Detailed instructions will be written and given to you for admission after fixing date of surgery.
Day of Admission
- Child can be admitted directly from the reception without having to visit the OP. The child can have a normal diet.
- He will be given a paediatric enema the day before and the morning of surgery
DAY OF SURGERY.
- The anaesthetist would decide from what time the child should fast. Usually this is for a minimum of 4 hours.
- After surgery, the child will be in the post operative intensive care ward .
- A parent may be allowed to sit with the child.
1ST POST OPERATIVE DAY
- Returns to the room in the morning
- He can move about.
2ND POST OPERATIVE DAY.
- Usually allowed to go home and asked to come back for review in a week.
Because of the slight increase in incidence of malignancy , in an undescended testis, the parents and later the child should learn to examine the testis regularly.