www.kjurology.org DOI:10.4111/kju.2010.51.3.155 Review Article An Evolution of Orchiopexy: Historical Aspect Kwanjin Park, Hwang Choi Department of Urology, College of Medicine, Seoul National University, Seoul, Korea The history of treatment for cryptorchidism dates back more than 200 years. This re- view is intended to highlight some historical aspect that led us to our current surgical treatment of this condition. The medical and historical surgical literatures pertaining to cryptorchidism were reviewed. Data sources were PubMed, Embase, conference pro- ceedings, and bibliographies. No language, date, or publication status restrictions were imposed. The study of cryptorchidism began with the anatomical descriptions of Baron Albrecht von Haller and John Hunter. Attempts at surgical correction of the un- descended testis began in the early 1800s, culminating in the first successful orchiopexy by Thomas Annandale in 1877. Max Schüller, Arthur Dean Bevan and Lattimer con- tributed to the establishment of current techniques for standard orchiopexy. Later, lap- aroscopy, high inguinal incision (Jones’ approach) and scrotal approach were added to the list of current orchiopexy. Key Words: Cryptorchidism; Orchiopexy; History Article History: received 26 February, 2010 accepted 9 March, 2010 Corresponding Author: Kwanjin Park Department of Urology, College of Medicine, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul 110-744, Korea TEL: +82-2-2072-0695 FAX: +82-2-742-4665 E-mail: urodori9@snu.ac.kr INTRODUCTION Cryptorchidism (from the Greek kryptos, meaning “hidden,” and orchis, meaning “testis”) refers to the ab- sence of a testis from the scrotum. Isolated cryptorchidism is the most common congenital anomaly of the male geni- talia, affecting almost 1% of full-term infants at the age of 1 year [1]. During embryonic life, the testes form beside the mesonephric kidneys and descend via the inguinal canal to the scrotum. If this process is faulty, a cryptorchid testis may halt along the normal path of descent (undescended or retractile testis), may travel off the normal path of decent (ectopic testis), or may die or never develop (absent testis). 　The history of the study of cryptorchidism and the first attempt to correct it began in the 18th century. Like other areas of medicine, which is a combined action of art and sci- ence, the progress of techniques in orchiopexy has been supported by an improved understanding of cryptor- chidism. In this context, this review aimed to describe the historical landmarks in the progress of orchiopexy in paral- lel with the growing knowledge of cryptorchidism that had spurred the technical advances in orchiopexy. THE ERA OF PIONEERS The theoretical bases that justify orchiopexy in patients with cryptorchidism originated from some critical ob- Korean Journal of Urology Ⓒ The Korean Urological Association, 2010 servations by two pioneers in the 18th century, Baron Albrecht von Haller and John Hunter. Over the ensuing years, theories on the mechanism of descent, and study of the histological and physiological alterations in the cryp- torchid testis came out, aiding the development of orchiopexy. 　Baron Albrecht von Haller, who became the Chairman in Anatomy and Surgery at Göttenger University in the 1730s, described the abdominal position of the fetal testis in his famous work ‘Opuscula Pathologica,’ published in 1755. In the chapter regarding congenital hernia, he accu- rately indicated the presence of abdominal testis, though he did not know the exact timing of testicular descent. Also, his explanation of the phenomenon responsible for the de- scent of the testis was wrong. However, it was important that his description attracted the interest of John Hunter, who later made some great observations that still hold true today. 　John Hunter is known as one of the fathers of modern sur- gery and anatomy. He was born on a small farm near Glasgow, Scotland, in 1728, the youngest of 10 children. Among his 10 siblings, he and his older brother William made a significant contribution to medicine. They founded the first independent anatomical school in London. John Hunter was a brilliant anatomist with unending curiosity, a variety of interests, and a colorful character. Although William wanted his younger brother to be a classic gentle- 155 Korean J Urol 2010;51:155-160