To investigate the feasibility of laparoscopic two-stage Fowler-Stephens operation (F-S operation) in the treatment of abdominal undescended testis.

A retrospective analysis was performed on 35 children (37sides) with abdominal undescended testis from September 2014 to October 2018 in Nanfang Hospital affiliated to Southern Medical University and Zhangjiajie Hospital of Traditional Chinese Medicine. Among them, 29 patients (31sides) completed the secondary F-S operation, and the Color Doppler Ultrasound was performed 6 months after the secondary surgery to assess testicular atrophy (28 patients completed the follow up, 1 patient lost to follow up).

Among 26 children with unilateral abdominal undescended testis, 22 sides (84.62%)had normal testicular blood supply, testicles were located in the scrotum and the diameter of testicles ≥1 cm. 4 sides (15.38%) presented testicular atrophy post-operation. 2 cases of bilateral abdominal undescended testis (4 sides, 100%) all had bilateral testicular atrophy post-operation. There was significant difference in testicular atrophy rates between the two groups of unilateral abdominal undescended testis and bilateral ones (P=0.003). There was no significant difference in testicular atrophy rates between different age groups and different distance between the testicle and the inner ring mouth within the abdominal cavity (P>0.05).

The rate of testicular atrophy after Laparoscopic two-stage F-S operation was not low, patients should to be selected carefully. For the cases with the testicular position located within 2cmof the opening of the inner ring, one-stage laparoscopic testicular descending fixation operation should be performed directly to reduce the incidence of postoperative testicular atrophy. For bilateral abdominal undescended testis cases, two-stage surgery can be considered. If atrophy occurs on one side after surgery, then the surgical method for the other side should be consider without cutting off the spermatic vessels.