microvascular anastomosis to maximize testicular blood supply after mobilization of the testicles (to get around the high variability in blood supply can complicate the Fowler-Stephens procedure). It takes a lot of microvascular surgical skill, specialized instrumentation, and is a much longer procedure. For fixation of testicular torsion Two distinct techniques used for surgical fixation are the sutured point-fixation and Jaboulay tunica plication. Multiple studies have shown that both are effective techniques for fixation with limited evidence favoring either in acute torsion. Sutured fixation may be performed using either absorbable or non-absorbable sutures, with 3 point fixation sites being preferred. There are concerns regarding potential complications arising from suture fixation (and required breach of the tunica albuginea) like infarction and abscess formation, however this is not supported by data. the Jaboulay procedure was developed later as a non-suture fixation method that avoids trans-parenchymal sutures and instead utilizes eversion, loose plication, and adhesion formation. this technique is criticized for potential security inadequacy. Overall, there is considerable variation in surgical practice for testicular fixation for testicular torsion, with no significant difference in effectiveness between sutured and Jaboulay fixation in emergency re-presentations, post-operative complications, or returns to operation. History The first attempts at surgical correction of cryptorchidism began in the early 1800s. Before this, inguinal testis were managed with the use of truss or castration, if at all. The theory of orchiopexy is attributed to the observations of Baron Albrecht von Haller and John Hunter in the 1700s, who began to elucidate the anatomy and mechanism of testicular descent. The first recorded attempt for surgical correction of an undescended testis was performed by James Adams in the London Hospital in 1871, although there are reports of attempts by several German doctors (J. F. Rosenmerkel in 1820 and M.J. von Chelius in 1837). The patient died due to infectious complications of the procedure. Thomas Annandale completed the first successful orchiopexy in 1887 on a three-year-old boy. He discussed the care of this patient in The British Medical Journal, crediting Thomas Curling (who had worked with James Adams) with the idea of anchoring the testis to the bottom of the scrotum. Notably, Annadale was a close acquaintance of Joseph Lister, and practiced antiseptic techniques that had been absent from previous attempts by other physicians. The postoperative course was reported to be “satisfactory in every way”. Max Schüller, Arthur Dean Bevan, and John K. Lattimer further contributed