Pasquale Casale and Douglas A. Canning

Various imaging modalities, i.e. pneumoperitoneography, ultrasonography, CT and MRI, have been used to locate impalpable testes in boys, but none are as accurate as laparoscopy. Laparoscopy was initially used as a diagnostic tool for evaluating patients with impalpable testes until Jordan et al. introduced the therapeutic application of laparoscopy in boys with undescended testis [1,2]. Further advancement in laparoscopic instrumentation and refined techniques has allowed laparoscopic orchidopexy to become the treatment of choice for impalpable testes. Many investigators have reported their success rate in placing the testis into the scrotum by laparoscopic procedures. One of the largest series by Chang et al. had an excellent outcome with an overall success rate of 85% and a 96% success rate on testes that had no previous surgery [3].