Simultaneous laparoscopic TAPP repair and varicocelectomy in a recurrent left inguinal hernia patient: A video case report

Laparoscopic TAPP and varicocelectomy

Abstract

Recurrent inguinal hernias and varicoceles are common surgical conditions; however, their concurrent presentation and simultaneous laparoscopic management are rarely reported. A 34-year-old male presented with swelling and discomfort in the left groin and scrotum. He had a history of open anterior mesh repair for a left inguinal hernia four years prior. Physical examination and ultrasonography confirmed a recurrent left indirect inguinal hernia and grade II varicocele. The patient was scheduled for simultaneous laparoscopic transabdominal preperitoneal (TAPP) hernia repair and varicocelectomy. Dense adhesions related to the prior anterior hernia repair were carefully dissected. A 3D polypropylene mesh was placed and fixed in the preperitoneal space, followed by peritoneal closure with a V-Loc™ suture. The dilated pampiniform plexus veins were clipped and divided using LigaSure™, sparing the testicular artery. The procedure was completed without complications, and the patient was discharged the next day with a VAS score near zero. This video case demonstrates that simultaneous laparoscopic TAPP repair and varicocelectomy can be safely performed in selected patients with dual pathology. This combined approach minimizes operative burden, avoids multiple incisions, and optimizes patient recovery.