Laparoscopic one-stage vessel-sparing orchiopexy and two-stage laparoscopic Fowler-Stephens orchiopexy: a comparative study

Objective: To compare the surgical outcomes of laparoscopic one-stage vessel-sparing orchiopexy (1S-LSO) and two-stage Fowler-Stephens laparoscopic orchiopexy (2S-LFSO) in the management of intra-abdominal undescended testes (IAUT) located less than 2.5 cm from the deep inguinal ring. Materials and methods: A retrospective study was conducted on 75 intra-abdominal undescended testes (IAUT) in 65 pediatric patients who underwent laparoscopic orchiopexy between January 2021 and June 2024. Data collected included patient age, operative duration, perioperative complications, postoperative testicular position, and testicular volume. Outcomes were compared between the 1S-LSO group and 2S-LFSO group. Results: = 0.653). Conclusions: Both 1S-LSO and 2S-LFSO are safe and highly effective for the treatment of IAUT. Although success and atrophy rates did not differ significantly between groups, the significant increase in postoperative testicular volume observed only in the 1S-LSO group suggests a possible advantage in postoperative testicular growth during the observed follow-up period. The choice of technique should be guided by careful anatomical and intraoperative assessment, favoring the single-stage vessel-sparing procedure when conditions permit.