Concomitant closure of patent canal of Nuck during laparoscopic surgery

Indirect inguinal hernia is neglected by many female patients. When women u ndergo laparoscopy for infertility work-up or other gynaecological conditio ns, the hernia appears pressurized by the pneumoperitoneum. A large opening on the peritoneum followed by the patent canal of Nuck-as seen in the pati ent in this case report-is accompanied by a bulge above the labia major. Th is situation was treated with simple ligation of the canal of Nuck from the internal inguinal ring, and the vulvar bulging mass quickly disappeared, e ven while under pneumoperitoneal pressure. Laparoscopic hernia repair is cu rrently performed with a mesh prosthesis to cover the defect; however, in f emale patients it seems unnecessary to use such an invasive method designed largely for males. According to our experience, the concomitant simple clo sure method for female indirect inguinal hernia is a quick and simple proce dure, and deals with the problem during the same laparoscopy. In addition, disappearance of the bulging mass under the pneumoperitoneum offers a usefu l diagnostic test to secure hernia management.