{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:41:50Z","timestamp":1792176110091,"version":"4.4.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/Purpose:<\/jats:title>\n                    <jats:p>It is generally perceived that a primary laparoscopic orchiopexy has superior outcomes due to preservation of the testicular artery, and thus should be the choice when achievable. The two-stage laparoscopic Fowler-Stephens orchiopexy (LFSO) is considered superior regarding success rate compared to the one-stage procedure when the artery must be transected. Outcomes can be jeopardized when a primary orchiopexy is ultimately realized to be the incorrect procedure due to insufficient testicular artery length. It is preferable to decide the approach before initiating dissection, however, in reality, this does not always occur.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>It is generally perceived that a primary laparoscopic orchiopexy has superior outcomes due to preservation of the testicular artery, and thus should be the choice when achievable. The two-stage laparoscopic Fowler-Stephens orchiopexy (LFSO) is considered superior regarding success rate compared to the one-stage procedure when the artery must be transected. Outcomes can be jeopardized when a primary orchiopexy is ultimately realized to be the incorrect procedure due to insufficient testicular artery length. It is preferable to decide the approach before initiating dissection, however, in reality, this does not always occur.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Key surgical maneuvers implicated in the modified one-stage LFSO (M-LFSO) include preservation of a wide peritoneal flap between the vessels and the vas deferens, dissecting the vessels as proximal as possible and avoiding manipulation of the epididymis and vessels between the vas and epididymis when transferring the testis to the scrotum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Our cohort included 55 boys (59 testes). Median age and weight at surgery were 13.3 months (interquartile range [IQR] 9.2\u201332.4) and 10.4 kg (IQR 9.2\u201312.6). The mean operative time was 70 min (IQR 60\u201385). The median follow-up was 11 months (IQR 7\u201312). There was one case of testicular atrophy (2%) and two cases of suboptimal testicular position in the scrotum at 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>M-LFSO is a standardized approach for all cases of IAT regardless of testicular position. Preservation of a wide peritoneal flap and proximal dissection of the vessels may contribute to the adequate testicular blood supply. The proposed approach eliminates the need for intra-operative decision-making and for ancillary procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmas.jmas_312_21","type":"journal-article","created":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T07:34:32Z","timestamp":1654068872000},"page":"591-595","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Standardized single-stage laparoscopic Fowler-Stephens orchiopexy regardless of testis position"],"prefix":"10.4103","volume":"18","author":[{"given":"Amos","family":"Neheman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Shumaker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Grazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyal","family":"Kord","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Bondarenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kobi","family":"Stav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amnon","family":"Zisman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Noh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-16-20240828","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/S0022-5347(17)36151-7","article-title":"Anatomical, morphological and volumetric analysis: A review of 759 cases of testicular maldescent","volume":"149","author":"Cendron","year":"1993","journal-title":"J Urol"},{"key":"R3-16-20240828","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.1016\/j.juro.2010.01.035","article-title":"Is staging beneficial for Fowler-Stephens orchiopexy.A systematic review?","volume":"183","author":"Elyas","year":"2010","journal-title":"J Urol"},{"key":"R4-16-20240828","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/S0022-5347(01)63613-9","article-title":"Surgical management of the nonpalpable testis: The Children's Hospital of Philadelphia experience","volume":"159","author":"Kirsch","year":"1998","journal-title":"J Urol"},{"key":"R5-16-20240828","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/S0094-0143(21)01351-3","article-title":"Malignancy in the cryptorchid testis","volume":"9","author":"Martin","year":"1982","journal-title":"Urol Clin North Am"},{"key":"R6-16-20240828","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.urols.2012.10.005","article-title":"Management of boys with nonpalpable undescended testes","volume":"23","author":"Hsu","year":"2012","journal-title":"Urol Sci"},{"key":"R8-16-20240828","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1089\/end.2008.0158","article-title":"Laparoscopic Fowler-Stephens orchiopexy: The Westchester Medical Center experience","volume":"22","author":"Chang","year":"2008","journal-title":"J Endourol"},{"key":"R9-16-20240828","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/S0022-5347(01)65820-8","article-title":"Treatment of high undescended testes by low spermatic vessel ligation: An alternative to the Fowler-Stephens technique","volume":"156","author":"Koff","year":"1996","journal-title":"J Urol"},{"key":"R10-16-20240828","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann Surg"},{"key":"R11-16-20240828","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1007\/s003830050674","article-title":"Laparoscopic classification and treatment of the impalpable testis","volume":"15","author":"Hay","year":"1999","journal-title":"Pediatr Surg Int"},{"key":"R12-16-20240828","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.jpurol.2019.10.014","article-title":"Revisiting the success rate of one-stage Fowler-Stephens orchiopexy with postoperative Doppler ultrasound and long-term follow-up: A 15-year single-surgeon experience","volume":"16","author":"Wu","year":"2020","journal-title":"J Pediatr Urol"},{"key":"R13-16-20240828","doi-asserted-by":"crossref","first-page":"3158","DOI":"10.1007\/s00464-014-3574-y","article-title":"Mapping testicular blood supply in gubernaculum-sparing second-stage Fowler-Stephens procedure","volume":"28","author":"Ellis","year":"2014","journal-title":"Surg Endosc"},{"key":"R14-16-20240828","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1097\/01.ju.0000125242.43762.be","article-title":"Volumetric and histological findings in intra-abdominal testes before and after division of spermatic vessels","volume":"171","author":"Rosito","year":"2004","journal-title":"J Urol"},{"key":"R15-16-20240828","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/S0022-5347(05)68991-4","article-title":"Arterial supply of the human fetal testis during its migration","volume":"161","author":"Sampaio","year":"1999","journal-title":"J Urol"},{"key":"R16-16-20240828","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1590\/S1677-55382008000300010","article-title":"Laparoscopic diagnosis and treatment of nonpalpable testis","volume":"34","author":"Denes","year":"2008","journal-title":"Int Braz J Urol"},{"key":"R17-16-20240828","doi-asserted-by":"crossref","first-page":"75","DOI":"10.5152\/tud.2016.32392","article-title":"Laparoscopic one-stage Fowler-Stephens orchiopexy preserving gubernaculum","volume":"43","author":"Nayc\u0131","year":"2017","journal-title":"Turk J Urol"}],"container-title":["Journal of Minimal Access Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_312_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:57:16Z","timestamp":1787756236000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_312_21"}},"subtitle":["Modification of technique eliminates the need for intra-operative decision-making"],"short-title":[],"issued":{"date-parts":[[2022,10]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/jmas.jmas_312_21","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.742417860.793596680","asserted-by":"object"}]},"ISSN":["0972-9941"],"issn-type":[{"value":"0972-9941","type":"print"}],"subject":[],"published":{"date-parts":[[2022,10]]}}}