Laparoscopic total extraperitoneal treatment for a hydrocele of the canal of Nuck located entirely within the inguinal canal: A case report

A 43-year-old woman was diagnosed with a hydrocele of the canal of Nuck, for which laparoscopic total extraperitoneal excision was successfully undertaken. The hydrocele was located entirely within the inguinal canal and was barely visible at the internal inguinal ring, even with strong retraction. The inferior epigastric vessels were at risk of injury secondary to excessive tension when retracting the round ligament. To overcome these problems, the hydrocele was approached from the medial side of the inferior epigastric vessels across the transversalis fascia. This approach allowed us to reach the distal end of the hydrocele and avoid excessive traction on the vessels. Thus, a hydrocele of the canal of Nuck can be addressed successfully with minimally invasive laparoscopic total extraperitoneal excision. Approaching the hydrocele from the medial side of the inferior epigastric vessels across the transversalis fascia may be useful.