A Case of Endometriosis of the Canal of Nuck Completely Resected by Laparoscopic and Anterior Approach

Kanki Otsuka, Eiji Yoshida, Shuta Kuchida, Kei Sato, Tsuyoshi Kono, Yoshiko Keira, Akinori Takagane
In: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) · 2021 · vol. 82(7) , pp. 1423–1429 · doi:10.3919/jjsa.82.1423 · W4210355864
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

A 37-year-old woman with a right inguinal swelling and pain was diagnosed with Nuck canal hydrocele coexisting with endometriosis and a right inguinal hernia, which were successfully resected using laparoscopic and anterior approaches.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This paper reports a single 37-year-old woman with right groin swelling and pain in whom contrast-enhanced CT showed a cystic lesion continuous with the right round ligament and suggested endometriosis-associated hydrocele of the canal of Nuck, with concurrent right inguinal findings. Laparoscopy confirmed a cystic mass continuous with the round ligament and dilation of the right internal inguinal ring, diagnosing Nuck’s canal hydrocele together with a coexisting inguinal hernia. The authors performed an anterior approach after laparoscopic observation, dissecting the round ligament peripherally and then centrally to remove the cystic mass without damaging it, while simultaneously repairing the hernia using a TAPP technique, and they noted no ascites or adhesions. This paper is centrally about endometriosis — specifically an endometriosis of the canal of Nuck (with round ligament–continuous cystic lesion) completely resected using laparoscopic and anterior surgical approaches.

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Abstract

症例は37歳，女性．右鼠径部の腫脹と疼痛を主訴に当科を受診した．腹部造影CTで，右鼠径部に境界不明瞭な淡い造影効果を示す軟部陰影と，腹腔内に右子宮円靱帯と連続した嚢胞性病変を認め，子宮内膜症を併存したNuck管水腫が疑われ，切除の方針とした．腹腔鏡による観察で，右子宮円靱帯と連続した嚢胞性腫瘤と右内鼠径輪の開大を認め，Nuck管水腫と右外鼠径ヘルニアの合併と診断した．続いて，前方アプローチで多房性腫瘤を伴った子宮円靱帯を可及的に末梢側で切離した後，中枢側への剥離を追加し嚢胞性腫瘤を損傷することなく標本を摘出した．腹腔内に腹水や癒着は認めず，同時にtransabdominal preperitoneal approach（TAPP法）でヘルニア修復術も施行した．Nuck管水腫の治療は完全切除が重要であり，自験例のように病変の局在が鼠径管から腹腔内まで広範に至ることもあるため，本術式が完全切除に有用であると考えられた．
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症例 腹腔鏡下と前方アプローチにて完全切除した子宮内膜症併存Nuck管水腫の1例 2021 年 82 巻 7 号 p. 1423-1429 詳細 抄録 症例は37歳，女性．右鼠径部の腫脹と疼痛を主訴に当科を受診した．腹部造影CTで，右鼠径部に境界不明瞭な淡い造影効果を示す軟部陰影と，腹腔内に右子宮円靱帯と連続した嚢胞性病変を認め，子宮内膜症を併存したNuck管水腫が疑われ，切除の方針とした．腹腔鏡による観察で，右子宮円靱帯と連続した嚢胞性腫瘤と右内鼠径輪の開大を認め，Nuck管水腫と右外鼠径ヘルニアの合併と診断した．続いて，前方アプローチで多房性腫瘤を伴った子宮円靱帯を可及的に末梢側で切離した後，中枢側への剥離を追加し嚢胞性腫瘤を損傷することなく標本を摘出した．腹腔内に腹水や癒着は認めず，同時にtransabdominal preperitoneal approach（TAPP法）でヘルニア修復術も施行した．Nuck管水腫の治療は完全切除が重要であり，自験例のように病変の局在が鼠径管から腹腔内まで広範に至ることもあるため，本術式が完全切除に有用であると考えられた． © 2021 日本臨床外科学会

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