Objective:

Lipomas or lipomatous structures in the spermatic cord or round ligament are often encountered during the inguinal canal exploration for laparoscopic or open inguinal hernia repairs. As the primary aim of the operation is the hernia repair, approach to these structures is controversial. In this study the incidence of spermatic cord and round ligament lipomas were demonstrated, and their association with hernia type and BMI (Body mass index) were discussed in the light of the literature.

Material and Methods:

In this retrospective study, 63 cases of spermatic cord and round ligament lipomas had been evaluated out of 327 open hernia repair operations, performed by a single general surgeon between April 2009 and 2014.

Results:

Of the patients 308 had unilateral hernia, with 286 males (92.9%) and 22 females (7.1%), whereas nineteen (6.2%) had bilateral inguinal hernia. The mean age of the 63 patients with lipomas was 43.6 (25-72), whereas that of the patients without lipomas was 41.2 (15-83). The pathological results of all the lipomatous structures were benign. BMI of the patients with and without lipomas were correspondingly 26.7 and 25.8., and the difference was not statistically significant, (p>0.05). The incidence of lipoma was significantly increasing in the patients with wide hernia pouch and wide internal inguinal ring (Nyhus Type 2, 3A ve 3B), (p<0.05).

Conclusion:

Inguinal canal lipomas observed during the inguinal hernia repairs are usually benign, and their excision should be made due to the risk of malignant transformation, recurrence prophylaxis and/or the mass effect. The painstaking care must be taken not to traumatize the ductus deferens, testicular artery and veins during the lipoma excisions for males.

Keywords: Inguinal hernia, hernia surgery, inguinal canal, spermatic cord, round ligament, lipoma