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Gapany, C., Frey, P., Cachat, F., Gudinchet, F., Jichlinski, P., Meyrat, B.-J., Ramseyer, P., Theintz, G. and Bumand, B. (2008) Management of Cryptorquidism in Children: Guidelines. Swiss Medical Weekly, 138, 492-498.

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• TITLE: High Undescended Testis Treatment with Distal Espermatic Vessel Ligation (Koff-Sethi Technique)

  AUTHORS: Carlos A. F. Molina, Andrey G. Estevanato, Marcelo F. Cassini, Murilo F. Andrade, Silvio Tucci

  KEYWORDS: Cryptorchidism, Orchiopexy, Ischemia, Reperfusion

  JOURNAL NAME: Surgical Science, Vol.5 No.6, June 23, 2014

  ABSTRACT: Objectives: To evaluate the results obtained with the technique of distal spermatic vessel ligation in children with upper or intra-abdominal undescended testis. Methods: Analysis of cryptorchid patients treated with Koff-Sethi technique for orquiopexy. Patient series: 15 children with uni- or bilateral cryptorchidism. Postoperative gonad viability was evaluated on the basis of clinical data, physical examination and testicular scintigraphy. Results: Mean age was 5.4 years. Cryptorchidism was unilateral in 10/15 (67%) patients and bilateral in 5/15 (33%). The total number of testicles operated was 25. Of these, 19/25 (76%) required ligation of the spermatic vessels performed according to the Koff-Sethi technique. Eighteen (98%) gonads remained well positioned in the scrotum and one remained in a high position. Late evaluation revealed that 14/19 (74%) testicles had normal consistency and volume upon palpation and 3/19 (16%) were atrophic. Two patients did not return for late reevaluation. Scintigraphy demonstrated good testicular perfusion in 14/17 (82%) gonads evaluated. The patient with bilateral ligation of the spermatic vessels had good perfusion in both gonads. Conclusions: Distal spermatic vessel ligation (Koff-Sethi technique) is safe and useful for the treatment of high cryptorchid testicles.