The role of self-efficacy and medication adherence in linking personality traits to health-related quality of life in middle-aged and older patients with chronic diseases.

Undescended testis is among the most common congenital anomalies of the pediatric genitourinary system, with an incidence of approximately 2%–4% in full-term male infants. If not treated in a timely and effective manner, undescended testis may impair spermatogenesis, disrupt endocrine function, and compromise long-term fertility. In addition, it is associated with an increased risk of testicular malignancy and inguinal-related complications [, ]. Therefore, achieving effective testicular descent and fixation while preserving vascular supply and function remains a central objective in pediatric surgery. With advances in minimally invasive techniques, laparoscopic orchiopexy has gradually replaced traditional open surgery and become a standard approach for the treatment of undescended testis []. Laparoscopy offers advantages in testicular localization, exposure of spermatic cord anatomy, and management of the processus vaginalis, thereby reducing tissue injury and improving surgical success rate []. However, conventional laparoscopic surgery (CLS) still requires multiple abdominal wall incisions. Moreover, in cases of palpable middle- to low-position undescended testes, the surgical pathway may be relatively complex, and intraoperative traction on the spermatic cord and inguinal tissues can increase the risk of postoperative pain, scarring, and complications []. Transscrotal orchiopexy has attracted increasing attention in the management of palpable undescended testes because of its concealed incision and short operative pathway. Nevertheless, its limited ability to address the intra-abdominal processus vaginalis and internal inguinal ring restricts the applicability of this single approach []. In recent years, the introduction of single-port laparoscopic techniques and the minimally invasive concept of hernia needle application has provided new possibilities for optimizing surgical approaches for undescended testis. Single-port laparoscopy reduces abdominal wall trauma while maintaining adequate intra-abdominal visualization. Meanwhile, hernia needle techniques enable high ligation of the internal inguinal ring, effectively minimizing peritoneal disturbance and the risk of associated complications []. Theoretically, the combination of single-port laparoscopic transscrotal orchiopexy with hernia needle (SPLT-Orchiopexy) techniques may facilitate sufficient testicular mobilization and safe descent while further reducing perioperative trauma, alleviating postoperative pain, and improving cosmetic outcomes []. However, systematic evaluations of the clinical efficacy, safety, and complication risks of this combined approach in children with palpable middle- to low-position undescended testes remain limited, and robust evidence is still lacking.