Laparoscopic surgery for a hydrocele of the canal of Nuck with an ovarian tumor: An extremely rare clinical finding

Tominaga, Marie; Morikawa, Kei; Ogawa, Yutaro; Kamimura, Naomi; Tsuneki, Ikunosuke; Takao, Masaki; Yanase, Toru; Kobayashi, Kazuaki; Sato, Daisuke; Kameyama, Hitoshi; Iwaya, Akira; Yokoyama, Naoyuki; Kuwabara, Shirou; Yamazaki, Toshiyuki; Otani, Tetsuya; Kurabayashi, Takumi

doi:10.1002/ccr3.5320

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…In recent years, there have been a few reports on successful totally laparoscopic resection and hernioplasty for HCN. To the best of our knowledge, there are only 10 reports (n = 13) including our case [4,5,8,10,[12][13][14][15][16] (Table 1). According to the HCN location, Wang et al recommended the following approaches: anterior approach for type A, laparoscopic TAPP exploration plus the anterior approach for type B, laparoscopic TAPP approach for type C, and laparoscopic TAPP or totally extraperitoneal approach plus the anterior approach for type D. In the present case, preoperative physical examination, CT scan, and MRI were conducted to diagnose type D hydrocele accompanied with a large protrusion into the abdominal cavity and enlargement of the deep inguinal ring.…”

Section: Discussionmentioning

confidence: 99%

Totally laparoscopic surgery for a hydrocele of the canal of Nuck extending from the abdominal cavity to the subcutaneous space: a case report

Nakamura,

Higashiguchi,

Chikaishi

et al. 2024

surg case rep

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Background Hydrocele of the canal of Nuck (HCN) is a rare disease, and its indications for laparoscopic surgery are not well-established. Case presentation A 53-year-old woman was referred to our hospital due to an uncomfortable thumb-sized inguinal mass. Preoperative computed tomography scan and magnetic resonance imaging revealed a hydrocele extending from the abdominal cavity around the left deep inguinal ring via the inguinal canal to the subcutaneous space. The patient was diagnosed with HCN protruding into the abdominal cavity and extending to the subcutaneous space. Laparoscopy can easily access the hydrocele protruding into the abdominal cavity. Furthermore, laparoscopic hernioplasty can be superior to the anterior approach for females. Hence, laparoscopic surgery was performed. After transecting the round ligament of the uterus, a tense 3-cm hydrocele was dissected with it. In order to approach the hydrocele distal to the deep inguinal ring, the transversalis fascia was incised medially to the inferior epigastric vessels. The subcutaneously connected hydrocele was excised from the incision. Then, the enlarged deep inguinal ring was reinforced using a mesh with the laparoscopic transabdominal preperitoneal approach. The patient was discharged 2 days postoperatively. Laparoscopic resection can be more effective for a hydrocele protruding into the abdominal cavity as it facilitates an easy access to the hydrocele. Moreover, laparoscopic resection of a hydrocele extending from the inguinal canal to the subcutaneous space via a transversalis fascia incision can be safer, with low risk of injury to the inferior epigastric vessels. The incised transversalis fascia and the enlarged deep inguinal ring due to the HCN were simultaneously repaired with the laparoscopic transabdominal preperitoneal repair. There are two reports on laparoscopic resection via a transversalis fascia incision for HCNs located between the inguinal canal and the subcutaneous space, which does not require intraperitoneal hydrocelectomy. However, this is the first report on laparoscopic resection of large HCNs protruding into the abdominal cavity and extending beyond the inguinal canal into the subcutaneous space via intraperitoneal hydrocelectomy and a transversalis fascia incision. Conclusions Laparoscopic surgery with transversalis fascia incision can be useful for HCNs extending from the abdominal cavity to the subcutaneous space.

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Section: Discussionmentioning

confidence: 99%

Totally laparoscopic surgery for a hydrocele of the canal of Nuck extending from the abdominal cavity to the subcutaneous space: a case report

Nakamura,

Higashiguchi,

Chikaishi

et al. 2024

surg case rep

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Bilateral Hydrocele of the Canal of Nuck in an Adult Female: A Case Report

Dhanju,

Kirkpatrick,

Goubran

et al. 2024

Journal of Diagnostic Medical Sonography

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Bilateral hydrocele of the canal of Nuck (HCN) is very rare, in adult females. Primary care physicians can misdiagnose this pathology without diagnostic imaging. A 37-year-old female complained of right lower quadrant (RLQ) pain, for a few months, reported to the emergency room. A non-reducible bulging protrusion was visualized in the RLQ. After performing the necessary blood work, the emergency physician ordered an emergent sonogram and computed tomography (CT). A transvaginal sonogram was performed to exclude gross adnexal masses, in the RLQ. An HCN canal was suspected in the right inguinal region. A non-contrast CT demonstrated a bilateral HCN, with the left significantly smaller than the right. In this case, a bilateral surgical excision of the hydrocele was recommended. Owing to the recurrence of the HCN, a cyst aspiration was not suggested. Physicians should consider the diagnosis of HCN in any female presenting with inguinolabial swelling. Sonography, CT, and magnetic resonance imaging (MRI) are the three diagnostic imaging techniques commonly used to diagnose this pathology. A multimodality approach is sometimes necessary when the sonography diagnosis is no definitve.

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Laparoscopic surgery for a hydrocele of the canal of Nuck with an ovarian tumor: An extremely rare clinical finding

Abstract: This clinical image presents an unusual report of simultaneous laparoscopic resection of a hydrocele of the canal of Nuck and an ovarian tumor. Laparoscopic treatment with a proper approach is a useful technique in some cases.

Cited by 2 publications

References 2 publications

Totally laparoscopic surgery for a hydrocele of the canal of Nuck extending from the abdominal cavity to the subcutaneous space: a case report

Totally laparoscopic surgery for a hydrocele of the canal of Nuck extending from the abdominal cavity to the subcutaneous space: a case report

Bilateral Hydrocele of the Canal of Nuck in an Adult Female: A Case Report

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