Undescended testes or cryptorchidism is a condition wherein the testicles fail to move down to its proper location. This condition may either be unilateral or bilateral and the testis can be palpable or nonpalpable within the normal course of descent. This presentation will be a case of bilateral intraabdominal testes and its surgical principles.

Diagnostic laparoscopy revealed intraabdominal testes just above the internal inguinal ring. Laparoscopic orchidopexy was then proceeded. Upon freeing of the spermatic chord, the vas deferens was then dissected from the peritoneal wall towards its insertion medially. Prior to delivering the testis to the desired scrotal location, sufficient length was estimated by bringing the testis to the contralateral inguinal ring. The left spermatic cord was sufficient to deliver the testis to the desired scrotal location, however tension was present in the right spermatic cord. Modified Prentiss maneuver was done to provide a straighter and shorter path, however tension persisted. A 2-stage orchidopexy was then decided intraoperatively. In preparation for the 2nd stage, the right testis was anchored to the suprapubic region.

The left testis was successfully inserted then carried down to the dartos pouch. Tension was present due to insufficient length of the right chord thus unable to deliver to the desired scrotal location. After 6 months, second stage orchidopexy was done on the right testes providing sufficient length and delivered to the scrotum.

A 2-stage orchidopexy is appropriate for this case and the 2nd stage orchidopexy would be done 6 months later. Limited studies are available regarding the lengthening of the chord after 6 months but pediatric urologists have applied this in their practice. As shown in the management of this patient. Both testes were eventually brought to the scrotum after the staged procedure.