Cord Lipoma - An Analogue of Preperitoneal Fat: A Laparoscopic Study

Sizable lipomas of spermatic cord were observed in the inguinal canals of 20 percent of adult male patients (N=25) who underwent laparoscopic total extra-peritoneal (TEPP) hernioplasty (N=30) for inguinal hernia. All cord lipomas were associated with a hernial sac – indirect 83% and direct 17%. Two-third of cord lipomas were small (1-2 cm) while one-third were moderate (2-4 cm) in size. All consisted of unencapsulated localized condensation of large easily separable fat globules composed of mature adipose tissues which was in direct continuity with preperitoneal fat of inguino-pelvic region along with vascular connections. Lipomas along with cord structures were enclosed within the internal spermatic fascia which was continuous with preperitoneal fascia covering the preperitoneal fat. Present study confirms that the so-called cord lipoma is really an analogue of preperitoneal fat and that dedicated laparoscopic work is required to realize their actual significance especially with respect to the cause-and-effect relationship with herniation.