Surgical video: spermatic cord lipomas are a common incidental finding during surgical treatment for inguinal hernias. They are found in 20–70% of all inguinal hernia repairs. They appear to arise from the retroperitoneal tissue and bulge through the internal ring of the inguinal canal and can be clinically indistinguishable from hernias. The importance of spermatic cord lipomas is poorly understood. The clinical picture of an inguinal hernia with bulging and pain but without an actual indirect hernia sac may become manifest in up to 8% of these cases. Missed spermatic cord lipoma can result in recurrence or pseudo-recurrence.
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