Clinical impact of laparoscopic traction in the treatment of high non-palpable testes

Cryptorchidism, also known as undescended testis, is the most prevalent genitourinary anomaly observed in males, with an overall incidence of approximately 3% in full-term neonates and increasing to as much as 30% in preterm infants. In the early months of life, the natural and physiological descent of the testes may occur without complication. Cryptorchidism is identified in 1 to 2% of cases by the age of three months and diminishes to 0.8 to 1.2% among males by the age of one year. For the treatment of UDT, several procedures have been reported, with laparoscopic orchiopexy being the gold standard. One or two phases of Fowler-Stephens laparoscopic orchiopexy (FSLO) are possible. The testicular arteries are divided in the first step of FSLO to facilitate appropriate testis mobility into the scrotum. The second stage FSLO is done 6-9 months after vessel ligation to allow collateral vessels supplying the testis to be developed to allow adequate mobilization to the scrotum. Staged laparoscopic-traction technique (Shehata approach) is a two-stage technique based on lengthening testicular vessels, which facilitates reposition of testis down to scrotum without testicular vessels division. The aim of this review article is to highlight short-term outcomes of staged laparoscopic traction approach for intra-abdominal undescended testis.