細径腹腔鏡（2mm径）による非触知停留精巣の診断と治療

Management of nonpalpable testis using microlaparoscopy

◆要旨：目的●非触知精巣の診断・治療として，当科では2mm径細径腹腔鏡を用いており，その手技および診断・治療について考察する．方法●1997～2004年に経験した非触知精巣20例24側を対象とし，全例に細径腹腔鏡を行い，14例14側は鼠径管への下降を確認した．腹腔内精巣の初期の2例4側は開腹術を施行．それ以降の5例6側は腹腔鏡下手術を行った．全例に術前超音波，MRI検査を施行した．結果●腹腔鏡下手術中，合併症はなかった．術前検索にて局在診断できた例はなく，全例が腹腔鏡にて診断された．結語●細径腹腔鏡による非触知精巣の診断・治療は有用であり，術前検索の精度を考慮すると，診断手技として第一選択になりえる．

　＜Introduction＞We describe the management of nonpalpable testis in children using micro laparoscopy. ＜Methods＞In a 7-year period, a total of 20 patients with 24 nonpalpable testes underwent microlaparoscopic procedure at our hospital. Fourteen testes of vas and vessels were found entering the internal inguinal ring. The first 4 intraabdominal testes in 2 patients underwent open procedure. Recent 6 intraabdominal testes in 5 patients underwent microlaparoscopic procedure. All 20 patients underwent ultrasonography and MR imaging as the preoperative evaluation. ＜Result＞Microlaparoscopic procedures were performed successfully without complications. There was no testis of localization in ultrasonography and MR imaging. ＜Conclusions＞Microlaparoscopy is an effective procedure for management of nonpalpable testis in children. Considering the accuracy of preoperative evaluation, microlaparoscopy may become a primary procedure for nonpalpable testis.