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Pre-scrotal access in inguinal-scrotal pathologies
Dr. GERMAN QUEVEDO P. FACS FAAPPediatric and Urology ServiceJapanese University Hospital
Santa Cruz - Bolivia
II World Congress of the World Federation of Association of Pediatrics Surgeons
VII Congress of the Federation of Pediatric Surgical Associations of the South Cone of America
Argentina - 2007
To present an alternative for the inguinal-scrotal pathologies
To discuss the advantages and disadvantages of this access
To present our experience with this access
OBJETIVES
Pre-scrotal access
Prospective work, from July 2004 to August 2007
Total: 220 patients
Inguinal Hernia 92Inguinal Cysts 20Undescended reticules 68 Hydrocele 22Acute scrotum 9Testicular prosthesis 3Testicular tumors 4Testicular torsion 2
Ages: from 4 m a 13 y ( medium 4,8 y )
All surgeries were done by the same Pediatric Surgeon
MATERIAL AND METHODS
RESULTS• Palpables Undescended Testicules
70% were found in the inferior inguinal chanel 30% were found in the medium inguinal chanel
• 80% The aponeurotic fascia was respect
• 100% got a scrotal position 80% satisfactory 20% scrotal high position
• Medium surgical time was 30 min.
• Controls after 20 months of surgeries80% return 100% success
Corionic gonadotrofine
• Inguinal Hernia, Inguinal Cysts, Hydrocele
- No relapse were found in any case- 100% were not opened the aponeuroses
• Testicular tumors• Considering the tumorals sizes, the surgical time was to short
• Testicular torsion • Immediate access with minimal mobilization for
element's evaluation
RESULTS
Short surgical time Minimal learn curve High percentage of respecting aponeuroses Only one incision for UDTs Easy access to the scrotum in UDTs Easy access and quickly evaluation in: Hydrocele, T. Tumors Acute scrotum, Inguinal hernia No manipulation in T. Tumors Excellent option for people that need to return to physical activity Excellent cosmetic
Conclusion
Orchidopexy??