Special Surgical Procedures II
LESSON 3: Procedures in Genitourinary Surgery
Section v: operations on the scrotum, penis, and urethra
3-37
3-37. ORCHIOPEXY
a. General. This operation involves the suspension of the testis within the scrotum. An undescended (cryptorchid) testis is one that has failed to move properly into the normal intrascrotal position. A retractile testis is one that has descended through the inguinal canal but lies either within or superficial to the external ring. An ectopic testis is one that has descended through the canal and rests in an abnormal position (the perineal femoral area or lateral to the canal). When this operation is done on young boys, the primary goal is to obtain adequate length of the spermatic vessels and the vas to allow the testis to lie in the scrotum.
b. Operative Procedure (Transverse Inguinal Approach).
(1) An incision is made at the internal inguinal ring, the inguinal canal is opened, and the testis and cord freed. Another incision is made at the external inguinal ring and the testis is brought through the incision and into the scrotum to the proper side.
(2) The reconstruction of the muscle closure of both the internal ring and the external oblique is accomplished, using fine interrupted silk or chromic sutures.
(3) The subcutaneous tissue and skin are closed with fine sutures, as desired.
