The Western snip, stitch, and tug hydrocelectomy: How I do it

Abstract

Introduction: Adult idiopathic hydrocele is a common benign disorder that merits surgical correction when symptomatic. The most popular techniques for repair are plication (Lord's procedure) or excision and eversion of the tunica vaginalis (Jaboulay procedure). Established complications from these traditional repairs include hematoma, recurrence, and infection. These procedures are performed through a scrotal incision. We describe a novel technique of hydrocele repair with gubernaculum preservation through a subinguinal incision. Methods: The novel technique is described in detail. A retrospective review was performed of those patients treated by a single surgeon with the subinguinal technique. Demographic information, indication for treatment, success rate, and details regarding complications were collected. Results: We term the technique the "Snip, Stitch & Tug" repair. Through a small subinguinal incision, the tunica is everted posterior to the spermatic cord and testis without resection of the hydrocele sac or division of the gubernaculum. Twelve patients with postoperative followup were identified. Eleven patients (92%) treated with the novel technique were cured. There was only one complication (superficial wound infection) recorded after this technique. Conclusions: Idiopathic hydrocele repair with gubernaculum preservation can be easily and safely performed through a small subinguinal incision.

Recurrent testicular torsion post orchidopexy ‐ an occult emergency: a systematic review

“…In seven (15.2%) cases, the authors simply reported that the testes were fixed bilaterally. 21,24,37 In another seven cases it was described as fixation of the testes to the dartos (n = 5, 10.9%), 35,36 scrotal wall (n = 1, 2.2%) 18 and tunica vaginalis (n = 1, 2.2%), 27 in four cases it was described as fixation of the tunica albuginea to the scrotal wall (n = 2, 4.4%), 17,31 the septum (n = 1, 2.2%) 26 and the tunica vaginalis (n = 1, 2.2%), 37 while in eight (17.4%) cases, 14,23,27 Jaboulay's technique (external eversion of the tunica vaginalis with suturing of the free edges posterior to the spermatic cord) 38 was used.…”

A comparison of a novel endoscopic “Su-Wang technique” with the open “Jaboulay’s procedure” for the surgical treatment of adult primary vaginal hydrocele

“…Procedures were successfully completed for all 42 patients. Although some researchers 12 have performed hydrocelectomy in an outpatient setting, we recommended 3 days of hospitalization in case of any unexpected AEs.…”

Office-based, Minimal-Incision Modified Fenestration Technique for Symptomatic Hydroceles Under Local Anesthesia

“…We identified favorable early outcomes in men undergoing our MIMFeT for treatment of symptomatic hydroceles. 6,12,[19][20][21] This procedure can be performed safely and effectively in the office under local anesthesia. In the current era of ever-increasing medical costs, the ability to perform this and other urologic procedures under local anesthesia has important and meaningful implications for our patients and the healthcare system as a whole.…”