Surgical video case: a lipoma of the cord is herniated fat that appears to originate from the retroperitoneal fat outside and posterior to the internal spermatic fascia and protrudes through the internal ring lateral to the cord. A spermatic cord lipoma is found in 20–70% of all inguinal hernia repairs. 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. They are generally not visible by transperitoneal inspection unless manually reduced. Missed spermatic cord lipoma can result in recurrence or pseudo-recurrence.
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