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Inguinal cord lipomas.

S Carilli1, A Alper, A Emre

  • 1General Surgery Department, VKF American Hospital, 80200, Istanbul, Turkey. carillis@yahoo.com

Hernia : the Journal of Hernias and Abdominal Wall Surgery
|April 24, 2004
PubMed
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Cord lipoma, fatty tissue in the spermatic cord, is common in indirect inguinal hernias. This study found a 72.5% incidence, suggesting it should be treated as a hernia.

Area of Science:

  • Hernia Surgery
  • Surgical Anatomy
  • Gastroenterology

Background:

  • Cord lipoma, fatty tissue within the internal cremasteric fascia, is frequently observed during hernia repair.
  • Its relationship with indirect inguinal hernias requires further clarification.

Purpose of the Study:

  • To evaluate the incidence of cord lipoma in patients undergoing open repair for indirect inguinal hernias.
  • To determine the association between cord lipoma and hernia characteristics such as size and patient BMI.
  • To propose a revised classification for inguinal hernias involving extraperitoneal fat herniation.

Main Methods:

  • Retrospective analysis of 128 consecutive patients with 139 indirect inguinal hernias between 1997 and 2001.
  • Open surgical repair with identification and resection of cord lipomas.

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  • Histopathologic examination of resected specimens.
  • Correlation analysis with hernia type (Nyhus classification) and patient Body Mass Index (BMI).

    • Main Results:

    • A total of 100 cord lipomas were identified and resected in 92 patients.
    • The incidence of cord lipoma associated with indirect inguinal hernia was 72.5%.
    • Higher incidence observed in larger hernias (Nyhus Type II and IIIb) (P<0.005) and a slightly higher average BMI in patients with lipoma (25.7 vs 24.6, P=0.048).
    • No neoplastic changes were found in histopathologic examinations.

    Conclusions:

    • Cord lipoma is a frequent finding in indirect inguinal hernias.
    • Herniation of extraperitoneal fat, even without a peritoneal sac, should be considered an inguinal hernia requiring treatment.
    • Laparoscopic findings support cord lipoma as a continuation of extraperitoneal fat.