Laparoscopic Treatment of Hydrocele of the Canal of Nuck in Pediatric Patients

Abstract

Introduction Hydrocele of the canal of Nuck (HCN) causes an inguinal swelling in pediatric females similar to that observed in case of inguinal hernia. HCN should be considered in the differential diagnosis of hernia in such children. Although laparoscopic operations have been reported in several cases for the treatment of HCN in adults, they have not been reported for the treatment in pediatrics. This study aimed to evaluate the outcomes of laparoscopic intracorporeal hydrocelectomy with high ligation as a treatment for HCN in pediatrics.

Materials and Methods I retrospectively reviewed the charts of 26 pediatric females aged ≤10 years who underwent laparoscopic hydrocelectomy with high ligation at Damsoyu Hospital, Seoul, Republic of Korea from September 2012 to December 2016.

Results The mean age was 3.31 (1–10) years. HCN was on the right in 11 patients and on the left in 15. The presenting symptom in all cases was inguinal swelling. HCN was of the hourglass type inside the inguinal canal in 17 patients and in the abdominal cavity outside the inguinal canal in 9. All patients were treated with laparoscopic hydrocelectomy with high ligation. The mean operating time was 17.8 minute (15–30). The wounds were scarcely visible immediately after surgery. There were no postoperative complications and no recurrences on follow-up.

Conclusion Laparoscopic intracorporeal hydrocelectomy with high ligation is effective for HCN in pediatrics owing to its short operating time, excellent cosmesis, and no recurrence.

Keywords

hydrocele of the canal of Nuck - laparoscopic hydrocelectomy - pediatric female

• References

• 1 Anderson CC, Broadie TA, Mackey JE, Kopecky KK. Hydrocele of the canal of Nuck: ultrasound appearance. Am Surg 1995; 61 (11) 959-961
• 2 Huang CS, Luo CC, Chao HC, Chu SM, Yu YJ, Yen JB. The presentation of asymptomatic palpable movable mass in female inguinal hernia. Eur J Pediatr 2003; 162 (7-8): 493-495
• 3 Ozel A, Kirdar O, Halefoglu AM. , et al. Cysts of the canal of Nuck: ultrasound and magnetic resonance imaging findings. J Ultrasound 2009; 12 (03) 125-127
• 4 Janssen K, Klinkner D, Kumar T. Encysted hydrocele of canal of Nuck: a case report with review of literature. J Surg Tech Case Rep 2011; 3 (02) 97-98
• 5 Park SJ, Lee HK, Hong HS. , et al. Hydrocele of the canal of Nuck in a girl: ultrasound and MR appearance. Br J Radiol 2004; 77 (915) 243-244
• 6 Akkoyun I, Kucukosmanoglu I, Yalinkilinc E. Cyst of the canal of Nuck in pediatric patients. N Am J Med Sci 2013; 5 (06) 353-356
• 7 Choi BS, Byun GY, Hwang SB, Koo BH, Lee SR. A comparison between totally laparoscopic hydrocelectomy and scrotal incision hydrocelectomy with laparoscopic high ligation for pediatric cord hydrocele. Surg Endosc 2017;
• 8 Matsumoto T, Hara T, Hirashita T, Kubo N, Hiroshige S, Orita H. Laparoscopic diagnosis and treatment of a hydrocele of the canal of Nuck extending in the retroperitoneal space: A case report. Int J Surg Case Rep 2014; 5 (11) 861-864
• 9 Bunting D, Szczebiot L, Cota A. Laparoscopic hernia repair--when is a hernia not a hernia?. JSLS 2013; 17 (04) 654-656
• 10 Counseller VS, Black BM. Hydrocele of the canal of Nuck: report of seventeen cases. Ann Surg 1941; 113 (04) 625-630
• 11 Mandhan P, Raouf Z, Bhatti K. Infected hydrocele of the canal of nuck. Case Rep Urol 2013; 2013: 275257
• 12 Ameh EA, Garba ES. Infected hydrocoele of the canal of Nuck in a neonate. Urol Int 2003; 71 (02) 226-227
• 13 Sarkar S, Panja S, Kumar S. Hydrocele of the canal of Nuck (female hydrocele): a rare differential for inguino-labial swelling. J Clin Diagn Res 2016; 10 (02) PD21-PD22
• 14 Lee SR, Choi SB. The efficacy of laparoscopic intracorporeal linear suture technique as a strategy for reducing recurrences in pediatric inguinal hernia. Hernia 2017; 21 (03) 425-433