Mayo stand and back table instruments for Orchiopexy surgery setupClamping & Occluding
Cutting & Dissecting
Grasping & Holding
Retracting & Exposing
Suctioning
Suturing & Stapling
What to expect during Orchiopexy
Orchiopexy is a surgical procedure that is performed to treat a condition known as cryptorchidism, which is the failure of one or both testicles to descend into the scrotum. During the procedure, the testicle is located and brought down into the scrotum, and then attached to prevent it from retracting back into the abdomen. Orchiopexy is typically performed in young boys to prevent potential complications such as infertility and testicular cancer that can arise from untreated cryptorchidism.
Positioning
Supine
Drapes
4 folded towels, laparotomy drape
Step 1: Incision and Dissection
During an Orchiopexy, a 15 blade will be used to make an incision on the scrotum or inguinal region, depending on the approach chosen by the surgeon. The surgical technologist should have a 15 blade on hand and ensure that it is sterile before the procedure begins. After making the incision, the surgeon will use a variety of instruments to dissect down to the inguinal ring or other anatomical landmarks that will allow them to locate the testis.
Step 2: Locating the Testis
Once the surgeon has reached the appropriate anatomical location, they will use instruments such as a scalpel or scissors to carefully dissect away any tissues that may be obscuring the testis. The surgical technologist should anticipate the surgeon’s needs and provide them with the necessary instruments as they work.
Step 3: Freeing the Spermatic Cord
After locating the testis, the surgeon will use instruments such as forceps to carefully free the spermatic cord from any torsion or other abnormalities that may be present. The surgical technologist should have a variety of forceps and other instruments on hand to assist the surgeon as needed.
Step 4: Placing Tacking Sutures
Once the spermatic cord has been freed, the surgeon may use tacking sutures to keep the fascia out of the way of the testis. This will allow the testis to have plenty of room to sit comfortably. The surgical technologist should provide the surgeon with the necessary sutures and needles and be prepared to assist with placing the sutures if needed.
Step 5: Controlling Bleeding and Closure
During the procedure, the surgical technologist should be prepared to assist with controlling any bleeding that may occur. This may involve using instruments such as a cautery or hemostats to stop bleeding at the surgical site. Once all bleeding has been stopped, the surgeon will close the incision using sutures or staples. The surgical technologist should be prepared to provide the surgeon with the necessary closure materials and assist with the closure as needed.
The Surgery Sparknotes
- Use a 15 blade to make an incision on the scrotum or inguinal region.
- Dissect down to the inguinal ring or other anatomical landmarks to locate the testis.
- Free the spermatic cord using forceps or other instruments.
- Use tacking sutures to keep the fascia out of the way of the testis.
- Control bleeding and close the incision using sutures or staples.
Does the specimen go to pathology like normal?
There usually isn’t a specimen during an orchiopexy since nothing is being removed (unless the doctor runs into some strange tissue or something that looks abnormal, but that is rare). However, there would be a specimen during an orchiectomy when the testicle is being removed. It would be sent to pathology like normal.