Laparoscopy through an inguinal hernia for diagnosis of intraperitoneal pathology

During the repair of an incarcerated inguinal hernia, a 68-year-old gentleman was found to have unsuspected ascites. Upon palpation of the peritoneal cavity through the hernial sac, superficial nodules could be appreciated, suggesting abnormal pathology. A laparoscope was placed through the hernia sac after establishing a pneumoperitoneum through the same approach. This allowed visualization of the entire peritoneal cavity and appropriate exploration of the abdominal viscera. Biopsies confirmed unsuspected metastatic renal cell carcinoma. The authors describe this technique and suggest possible indications for its use.