A Case of Endometriosis of the Canal of Nuck Completely Resected by Laparoscopic and Anterior Approach

Abstract

A 37-year-old woman visited our outpatient department with chief complaints of swelling and dull pain in the right inguinal region. The abdominal contrast-enhanced computed tomography revealed heterogeneous enhancement of the soft tissue and a cystic mass in the right inguinal region. The cystic mass was in contact with the right round ligament of the uterus in the peritoneal cavity. Our preoperative diagnosis was a hydrocele of the canal of Nuck associated with endometriosis. We selected the laparoscopic and anterior approach for complete resection of the hydrocele. During laparoscopic examination, the cystic mass was found to be contiguous with the right round ligament of the uterus, and there was an accompanying right internal inguinal hernia. The proximal part of the round ligament of the uterus with the cystic mass was carefully dissected into the inguinal canal by the laparoscopic approach. During the anterior approach, we detected a polycystic lesion on the peripheral round ligament of the uterus, which was resected completely. Additionally, the right inguinal hernia was repaired by the transabdominal preperitoneal approach because neither ascites nor adhesions were present in the abdominal cavity. The laparoscopic and anterior approach is one of the useful techniques for management of hydrocele of the canal of Nuck associated with endometriosis.