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Laparoscopic management of transverse testicular ectopia with persistent mullerian duct syndrome.

Kamble RS, Gupta RK, Gupta AR, Kothari PR, Dikshit KV, Kesan KK - J Minim Access Surg (2015 Jul-Sep)

Bottom Line: A 4-month-old male child presented with right undescended testis and left inguinal hernia with funiculitis.Mobilization of vessels, division of uterus, and hernia repair was done laparoscopically.On the review of literature, there is only one case report of total laparoscopic repair of transversetesticular ectopia (TTE) with hernia without persistent mullerian duct (PMDS).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Surgery, Lokmanya Tilak Muncipal Medical College and government Hospital, Sion, Mumbai, India.

ABSTRACT
A 4-month-old male child presented with right undescended testis and left inguinal hernia with funiculitis. Ultrasonography showed funiculitis on the left side testis along with presence of 1.5 × 1 cm testis like structure just above left testis and empty right scrotal sac without any evidence of mullerian structures. On diagnostic laparoscopy, right testicular vessels were crossing from right to left and had uterus with both testes in left hernia sac. Mobilization of vessels, division of uterus, and hernia repair was done laparoscopically. On the review of literature, there is only one case report of total laparoscopic repair of transversetesticular ectopia (TTE) with hernia without persistent mullerian duct (PMDS). The uniqueness of our case is that it had TTE with hernia and PMDS, which were totally managed by laparoscopy. On 6 months of follow-up, both the testes are palpable in scrotum.

No MeSH data available.


Related in: MedlinePlus

Photograph showing uterus in between two testis
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Figure 2: Photograph showing uterus in between two testis

Mentions: After recovery of funiculitis, we posted the patient for diagnostic laparoscopy followed by definitive repair. During the procedure, operating surgeon was at the head end. A 5 mm port was inserted at umbilicus forthe camera and two working ports were inserted 5 cm away on either side of the umbilical. Atlaparoscopy, right-sided internal ring was open with gubernaculum passing through it. Right-sided testicular vessels crossed from right to left, entering in left internal ring [Figure 1]. Contents of left inguinal canal were reduced. There was a uterus in between two testes [Figure 2]. Both vas deferences were running along the sides of uterus. Small hernia sac was also present. We divided the uterus in midline with help of bipolar cautery [Figure 3]. After mobilization of right testicular vessels we found adequate length to bring it out through right-sided internal ring. Small incision taken on both side of median raphe of scrotum. Laparoscopic-assisted tunnel was created on the right side of inguinal canal. Both testes brought out and fixed in the subdartous pouch. Left-sided hernial sac closed with intracaropreal suturing.


Laparoscopic management of transverse testicular ectopia with persistent mullerian duct syndrome.

Kamble RS, Gupta RK, Gupta AR, Kothari PR, Dikshit KV, Kesan KK - J Minim Access Surg (2015 Jul-Sep)

Photograph showing uterus in between two testis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499931&req=5

Figure 2: Photograph showing uterus in between two testis
Mentions: After recovery of funiculitis, we posted the patient for diagnostic laparoscopy followed by definitive repair. During the procedure, operating surgeon was at the head end. A 5 mm port was inserted at umbilicus forthe camera and two working ports were inserted 5 cm away on either side of the umbilical. Atlaparoscopy, right-sided internal ring was open with gubernaculum passing through it. Right-sided testicular vessels crossed from right to left, entering in left internal ring [Figure 1]. Contents of left inguinal canal were reduced. There was a uterus in between two testes [Figure 2]. Both vas deferences were running along the sides of uterus. Small hernia sac was also present. We divided the uterus in midline with help of bipolar cautery [Figure 3]. After mobilization of right testicular vessels we found adequate length to bring it out through right-sided internal ring. Small incision taken on both side of median raphe of scrotum. Laparoscopic-assisted tunnel was created on the right side of inguinal canal. Both testes brought out and fixed in the subdartous pouch. Left-sided hernial sac closed with intracaropreal suturing.

Bottom Line: A 4-month-old male child presented with right undescended testis and left inguinal hernia with funiculitis.Mobilization of vessels, division of uterus, and hernia repair was done laparoscopically.On the review of literature, there is only one case report of total laparoscopic repair of transversetesticular ectopia (TTE) with hernia without persistent mullerian duct (PMDS).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Surgery, Lokmanya Tilak Muncipal Medical College and government Hospital, Sion, Mumbai, India.

ABSTRACT
A 4-month-old male child presented with right undescended testis and left inguinal hernia with funiculitis. Ultrasonography showed funiculitis on the left side testis along with presence of 1.5 × 1 cm testis like structure just above left testis and empty right scrotal sac without any evidence of mullerian structures. On diagnostic laparoscopy, right testicular vessels were crossing from right to left and had uterus with both testes in left hernia sac. Mobilization of vessels, division of uterus, and hernia repair was done laparoscopically. On the review of literature, there is only one case report of total laparoscopic repair of transversetesticular ectopia (TTE) with hernia without persistent mullerian duct (PMDS). The uniqueness of our case is that it had TTE with hernia and PMDS, which were totally managed by laparoscopy. On 6 months of follow-up, both the testes are palpable in scrotum.

No MeSH data available.


Related in: MedlinePlus