A Case of Internal Inguinal Hernia with a Remaining Preperitoneal Fat Mass Resected after TAPP

Abstract

A 70-year-old man was admitted to a hospital with a right groin mass. Based on physical and abdominal computed tomography findings, we diagnosed a right direct inguinal hernia and performed transabdominal preperitoneal repair (TAPP). Three days later, he complained of the right groin mass again. Noting recurrence of the right inguinal hernia, we repeated the TAPP 7 days later. Laparoscopic observation revealed no peritoneal sac. However, we could palpate the right groin mass. Therefore, we also performed open inguinal repair, which revealed that the right groin mass after TAPP existed near the external inguinal ring and was composed of preperitoneal fat. We resected it and repaired the area using preperitoneal plug mesh. He was discharged from our hospital on the 6^th day after the reoperation.

A mass composed of remaining preperitoneal fat has not been reported to date as a complication of inguinal hernia. We present this case to educate clinicians about this possible complication after laparoscopic inguinal hernia repair.