Robot-assisted Laparoscopic Orchiopexy: A Comparative Analysis to Laparoscopic Orchiopexy

Abstract Background While undescended testes are relatively common, the nonpalpable testis remains a challenging problem. The gold standard treatment remains the laparoscopic orchiopexy. However, today robot-assisted surgery has challenged traditional laparoscopy in many areas of urology. Yet the value of this new approach remains controversial, given concerns with operative time and cost. We reviewed our contemporary results of both robot-assisted orchiopexy (RALO) and traditional laparoscopic orchiopexy (TLO). Our primary aim was to retrospectively compare operative time and cost. We also assessed complications and success rate. Methods In this study, all patients treated with laparoscopic and robot-assisted laparoscopic orchiopexy from April 2017 to January 2022 were reviewed using CPT code 54692. Exclusion criteria included bilateral concomitant orchiopexy or concomitant “major surgery.” Also excluded were 1st stage orchiopexies. Patient demographics, surgical operative notes and documentation were all reviewed. Results After exclusion criteria was applied, 24 and 22 remained in the laparoscopic and robot-assisted cohorts, respectively. The median operative time in the TLO group was 71 minutes, compared to 102 minutes in the RALO group (Fig. 1) (p > 0.0001). When comparing hospital charges, the TLO group was lower at $38,829, compared to $46,197 in the RALO group (Fig. 2) (p = 0.0069). There was one postoperative complication in the TLO group (localized wound infection), compared to zero in the RALO group. Conclusions The robot-assisted orchiopexy is safe and effective. However, at this time it remains more costly in terms of time and resources. Level of Evidence Level III