Case Report: Laparoscopic repair of indirect inguinal hernia combined with ipsilateral giant subcutaneous inguinoperineal lipoma.

Lipomas are common benign mesenchymal neoplasms with slow growth, consisting of mature adipocytes, while giant inguinal lipomas are rare because of anatomical limitations. This report describes a 46-year-old woman who presented with a reducible left inguinal mass and an ipsilateral painless giant subcutaneous mass. She was diagnosed with a left indirect inguinal hernia and a separate inguino-labial lipoma superficial to the external oblique aponeurosis, which was not adherent to the inguinal canal, round ligament or canal of Nuck. The coexistence of the two lesions was incidental. The patient underwent combined laparoscopic totally extraperitoneal (TEP) hernia repair and TEP-guided transfascial lipoma excision. Histopathology verified a mature lipoma without atypia or features of liposarcoma. We summarize the clinical manifestations, diagnostic points, anatomy, surgical techniques, pathological results and clinical outcomes of this rare condition, and confirm that single-stage TEP-guided transfascial lipoma excision is a safe and feasible procedure.