Laparoscopic Treatment for Lipoma in the Inguinal Canal without Hernia: Intracorporeal Lipoma Excision and Suture Repair of the Deep Inguinal Ring

Lee, Sung Ryul; Park, Pyoungjae

doi:10.4172/2165-7920.10001065

Cited by 1 publication

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“…• Spermatic cord lipoma without a hernia sac Only a spermatic cord lipoma without a real hernia sac was identified in open or laparo-endoscopic repair in up to 8% of clinically diagnosed inguinal hernias (4, 9, 10, 12). That problem arises if spermatic cord lipoma causes bulging even in the absence of a hernia sac (33)(34)(35)(36)(37). If a spermatic cord lipoma is not completely resected or dissected or even missed due to incomplete exploration of the inguinal canal, it may result in recurrence or pseudo-recurrence (33)(34)(35)(36)(37)(38)(39)(40).…”

Section: Different Clinical Scenariosmentioning

confidence: 99%

Spermatic Cord Lipoma—A Review of the Literature

Köckerling

Schug-Paß

2020

Front. Surg.

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Introduction: A spermatic cord lipoma is found in 20-70% of all inguinal hernia repairs. The clinical picture of an inguinal hernia with bulging and pain but without an actual indirect hernia sac may become manifest in up to 8% of these cases. Missed spermatic cord lipoma can result in recurrence or pseudo-recurrence. This review presents the relevant literature on this topic. Materials and Methods: A systematic search of the available literature was performed in February 2020 using Medline, PubMed, Google Scholar, Scopus, Embase, Springer Link, and the Cochrane Library, as well as a search of relevant journals and reference lists. Forty-two publications were identified as relevant for this topic. Results: Spermatic cord lipoma seems to originate from preperitoneal fatty tissue within the internal spermatic fascia in topographical proximity to the arteries, veins, lymphatics, nerves, and deferent duct within the spermatic cord. Reliable diagnosis cannot be made clinically, but rather with ultrasound, CT, or MRI. In the absence of a real hernia sac, a spermatic cord lipoma is classified as a lateral inguinal hernia with a defect size <1.5 cm according to the European Hernia Society (EHS LI). Missed or inadequately treated spermatic cord lipoma results in recurrence or pseudo-recurrence. Since spermatic cord lipoma obtains its vascular supply from the preperitoneal space, it can be reduced or resected. Conclusion: Spermatic cord lipoma is a common finding in inguinal hernia repairs and must be properly diagnosed and treated with care respecting the anatomy of the spermatic cord.

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