Objective To evaluate the feasibility of laparoscopic surgery with nonsutured internal ring for pediatric cryptorchidism complicated with ipsilateral indirect inguinal hernia. Methods 23 children with cryptorchidism complicated with ipsilateral indirect inguinal hernia were enrolled in this study. Laparoscopic surgery with nonsutured internal ring was performed in all cases. The initial management consisted of separation of the spermatic vessels and vas deferens, and establishment of a standard dartos capsule between the ipsilateral scrotal skin and dartos. Then the testicle was pulled down into the dartos, and the periorchium was fixed to the edge of scrotal dartos with suture. The internal ring was not sutured and closed in all cases. The operative duration, profile of testicular descending, and complications were assessed. Results Patent processus vaginalis was found in all cases. Of 23 cases, there were 20 cases with inguinal canal cryptorchidism, and 3cases with intraabdominal cryptorchidism. The mean operative duration was 53 min, and the mean intraoperative blood loss was 23.5mL. Primary orchidopexy was performed in 23 cases. Postoperative incision infection, testicular atrophy or retraction, recurrence of indirect inguinal hernia and adhesive ileus and umbilical hernia did not occur. Conclusions The laparoscopic surgery with nonsutured internal ring is a safe and effective approach for children with cryptorchidism complicated with ipsilateral indirect inguinal hernia. And it has the advantages of less trauma and faster recovery.

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