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Pre-scrotal access in inguinal-scrotal pathologies. Dr. GERMAN QUEVEDO P. FACS FAAP Pediatric and Urology Service Japanese University Hospital Santa Cruz - Bolivia II World Congress of the World Federation of Association of Pediatrics Surgeons
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Pre-scrotal access in inguinal-scrotal pathologies Dr. GERMAN QUEVEDO P. FACS FAAP Pediatric and Urology Service Japanese 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
Pre-scrotal access OBJETIVES 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
MATERIAL AND METHODS Prospective work, from July 2004 to August 2007 Total: 220 patients Inguinal Hernia 92 Inguinal Cysts 20 Undescended reticules 68 Hydrocele 22 Acute scrotum 9 Testicular prosthesis 3 Testicular tumors 4 Testicular torsion 2 Ages: from 4 m a 13 y ( medium 4,8 y ) All surgeries were done by the same Pediatric Surgeon
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 surgeries • 80% return 100% success RESULTS Corionic gonadotrofine
RESULTS • 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
Conclusion • 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