Necessity and safety of primary closure of the patent processus vaginalis in laparoscopic orchiopexy: protocol for systematic review and meta-analysis

INTRODUCTION: A patent processus vaginalis (PPV) is frequently observed during laparoscopic orchiopexy in infants with cryptorchidism. Nevertheless, the decision to primarily close the PPV following laparoscopic orchiopexy remains a subject of debate. This protocol therefore outlines the scope and methodology for a systematic review and meta-analysis that will synthesise the available evidence to evaluate the clinical outcomes associated with primary closure of the PPV after laparoscopic orchiopexy. METHODS AND ANALYSIS: A systematic electronic literature search will be conducted across PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov to identify eligible studies published before 31 May 2026. The methodological quality of the included studies will be assessed using the Cochrane Risk of Bias V.2 tool for randomised trials and the Risk of Bias in Non-randomized Studies of Interventions tool for non-randomised studies. The primary outcomes will include postoperative inguinal hernia, testicular atrophy and testicular ascent. Secondary outcomes will comprise operative time, estimated blood loss, length of postoperative hospital stay and overall 30-day postoperative complications. The robustness of the findings will be evaluated through subgroup analyses and sensitivity analyses. All statistical analyses will be performed using Stata 19.0 and RevMan Web, with statistical significance defined as a two-sided p < 0.05. The certainty of the evidence will be evaluated following the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. ETHICS AND DISSEMINATION: Ethical approval for this study based solely on aggregated and anonymised data is not required. Findings will be disseminated through peer-reviewed journals, conferences and interactive dialogues in this research area. PROSPERO REGISTRATION NUMBER: CRD420261289759.