A Case of Transverse Testicular Ectopia Diagnosed during Laparoscopic Surgery for Inguinal Hernia

Abstract

A 67-year-old man presented with left inguinal distension and was diagnosed with left inguinal hernia. Laparoscopic inguinal hernia repair was performed using a transabdominal preperitoneal (TAPP) approach. Intraoperatively, a cord-like structure was observed running from the left internal inguinal ring through the posterior side of the bladder to the right dorsal side. After peritoneal incision, both the right and left testicular vessels and vas deferens entered the left inguinal canal. Intraoperatively, the testes were palpable in the left hemiscrotum, whereas the right hemiscrotum was empty. Based on these findings, transverse testicular ectopia (TTE) was diagnosed. Intraoperative palpation and ultrasonography revealed no signs of malignancy. After consultation with urologists, neither orchiectomy nor orchiopexy was required. A mesh was placed after sufficient dissection of the spermatic cords, and the procedure was completed as planned. TTE is typically diagnosed during childhood, and reports of inguinal hernia repair using the TAPP approach in adults are extremely scarce. Here, we report a rare adult case with a review of the relevant literature.