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Purpose. – Impalpable and undescended testis is a very common preoccupation for specialized pediatric surgery teams. The laparoscopy as the single most accurate modality for diagnosis and localization of impalpable undescended gonad is well established by all authors. However the therapeutic attitude and the technique are still a matter of debate.Material and methods. – A series of 122 boys presenting an impalpable and undescended testis was studied. All the children beneficiated of a primary laparoscopic exploration. During this exploration, when a testis was found, the clamping of the spermatic vessel was made and the final descent took place few months later.Results. – In our study the testis was found in 60 cases and the spermatic vessel’s clamping assured the descent of a well vascularized testis in about 80% of cases.Conclusion. – Clamping the spermatic vessel during the laparoscopic exploration assured, thanks to the development of a supply, a good vascularisation of the testis during its second step descent. Our retrospective study has showed the good reliability of laparoscopic surgery as primary treatment in front of impalpable undescended testicles in comparison to the one-step classical orchiopexy. [Copyright &y& Elsevier]

Objective The treatment of ano- or rectovaginal fistula is still difficult. The use of the Martius flap is well described as an adjunctive technique in their repair. We report our experience of a modified Martius flap in the management of ano- or rectovaginal fistula. Method This is a retrospective study of 14 women presenting with an anovaginal ( n = 9) or rectovaginal fistula ( n = 5). All were treated by a modified Martius graft. The aetiology included Crohn's disease ( n = 7), ulcerative colitis ( n = 4), radio-induced ( n = 1), obstetric ( n = 1) and villous tumour ( n = 1). Results All 14 fistulas healed within the 3 months after surgery. Subsequently, two patients with Crohn's disease required an abdominoperineal resection owing to progressive anal lesions. Two other patients experienced faecal incontinence which improved with functional rehabilitation treatment. Conclusion A modified Martius flap is a valuable option in the treatment of ano- or rectovaginal fistula. In the case of Crohn's disease, however, the prognosis depends primarily on subsequent clinical evolution of the condition. [ABSTRACT FROM AUTHOR]