Laparoscopic surgical treatment for hydrocele of canal of Nuck: A case report and literature review

Abstract

Background Hydrocele of canal of Nuck (HCN) is a rare disease in adult female. The diagnosis and treatment of HCN is still a challenge for surgeons. Case presentation A 56-year-old female presented with recent onset of occasional pain during exercise and an asymptomatic left groin swelling. Ultrasonography results were suspicious for left inguinal hernia incarceration and computed tomography (CT) scan showed no intestinal obstruction, which was considered as HCN. Laparoscopic hydrocelectomy of the HCN and a routine laparoscopic hernia repair via the transabdominal preperitoneal (TAPP) approach were performed. Postoperative pathology showed no malignant lesions or endometriosis. Conclusions The preoperative diagnosis of HCN is extremely important. Surgeons should choose appropriate surgical methods for different anatomical HCNs based on the preoperative diagnosis.

Cyst and endometriosis of the canal of Nuck: rare differentials for a female groin mass

“…Referral to a general surgeon for elective open herniorrhaphy with excision of the cyst and mesh repair of the inguinal canal is recommended for definitive management. Laparoscopic techniques may be preferred by some surgeons; however, this could result in a longer and more difficult operation if the inguinal canal is deep or the CCN is too large, requiring conversion to an open approach [ 11 ]. Aspiration of the cyst is rarely curative and should be avoided as rate of recurrence is high.…”

Inguinal endometriosis: Ten case reports and review of literature

“…It is critical to diagnose IEM prior to surgery. Based on the preoperative diagnosis, surgeons should select suitable surgical techniques depending on the anatomical location of the IEM lesion[ 41 ]. When the general surgeon performs IH surgery and finds significant thickening of the hernia sac wall, adhesions, bloody fluid inside the sac, or significant thickening of the extraperitoneal round ligament and purple–blue lesions on the cut surface, the possibility of IEM should be considered, and a gynecologist should be asked to consult on the staging, remove the hernia sac and perform complete excision of the IEM lesion as well as evaluate the presence of pelvic EM and, if necessary, perform laparoscopic exploration, especially in patients with infertility.…”

The Cyst of the Canal of Nuck: Anatomy, Diagnostic and Treatment of a Very Rare Diagnosis—A Case Report of an Adult Woman and Narrative Review of the Literature

“…A recent classification was published by Wang et al in 2021 [ 30 ], who subdivided the cyst of the canal of Nuck into four groups according to its anatomical position. Type A is located subcutaneously over the inguinal canal, Type B resides inside the inguinal canal, Type C is confined to the internal inguinal ring, and Type D extends from the internal inguinal ring to the inguinal canal or subcutaneously.…”

“…Recent therapeutic approaches consider laparoscopic intervention for the treatment of female hydroceles [ 8 , 30 , 57 , 58 ]. In particular, the transabdominal preperitoneal (TAPP) and the totally extra-peritoneal (TEP) techniques are considered as popular laparoscopic methods, which can also be used in the treatment of cyst of the canal of Nuck [ 8 , 12 , 30 , 58 ]. Laparoscopy can not only be used as a treatment option, but also as an additional diagnostic method to determine the hydrocele and anatomical conditions.…”

“…Laparoscopy can not only be used as a treatment option, but also as an additional diagnostic method to determine the hydrocele and anatomical conditions. Compared with TEP, TAPP has a better diagnostic potential, due to the improved imaging of the abdominal cavity, its anatomical variations and the hydrocele itself [ 8 , 12 , 30 , 58 ]. However, sometimes difficult anatomical conditions may prevent a laparoscopic repair, requiring conversion to traditional open anterior surgery [ 59 ].…”