Unexpected Peritoneal Loose Body Discovered During Laparoscopic Varicocelectomy: A Case Report

BACKGROUND Peritoneal loose bodies (PLBs) are rare, benign intraperitoneal entities usually discovered incidentally during abdominal surgery or imaging. Their occurrence during urologic laparoscopy appears to be infrequently reported and may create intraoperative diagnostic uncertainty when encountered unexpectedly. CASE REPORT A healthy 22-year-old Jordanian man with no history of abdominal or pelvic surgery underwent bilateral laparoscopic varicocelectomy for symptomatic varicoceles. Dense sigmoid adhesions over the left internal inguinal ring required careful adhesiolysis to expose the spermatic vessels. During dissection, a smooth, freely mobile ovoid structure was identified within the left paracolic gutter and retrieved laparoscopically. Histopathological examination demonstrated necrotic adipose tissue with dystrophic calcification, confirming a PLB. The patient recovered uneventfully and reported resolution of his preoperative symptoms at the 3-week postoperative follow-up. CONCLUSIONS This report highlights that a PLB may be encountered unexpectedly even in a healthy patient with no history of abdominal or pelvic surgery who is undergoing an elective, limited-field laparoscopic urologic procedure. In the present case, the lesion's smooth surface, complete mobility, lack of visible vascular attachment, and firm, rubbery consistency supported intraoperative consideration of a benign PLB. This observation supports awareness that a similar freely mobile, avascular intraperitoneal body encountered unexpectedly during laparoscopy may represent a benign PLB; however, broader management implications cannot be established from a single case. Histopathological confirmation remains important when the diagnosis is uncertain.