Resection of mesothelial cyst of uterine round ligament by laparoscopic transabdominal preperitoneal procedure alone or combined with open surgery

Abstract

Objective: Surgical treatment of a mesothelial cyst of the uterine round ligament (MCURL), an uncommon entity, has been rarely documented. In this article, we present our experience with excision of MCURLs.

Methods: The records of all female patients undergoing surgical removal of a groin mass in our department from March 2013 to November 2018 were retrospectively reviewed. Demographic information, clinical data, and follow-up outcomes were collected and analyzed.

Results: Among 298 women who underwent groin hernia repair, 17 (5.7%) had MCURLs. Of these 17 patients, 13 were aged 30 to 45 years and 15 had a normal body mass index (18.5–23.9 kg/m²). MCURLs occurred predominantly on the right side (11/17). Approximately half of the patients (9/17) were preoperatively misdiagnosed with inguinal hernias. Approximately 70% (12/17) of the lesions were localized medially to the inner ring of the inguinal canal and excised by a laparoscopic transabdominal preperitoneal (TAPP) procedure alone. Five patients required open surgery following the TAPP procedure because the cyst extended distally beyond the inner ring. No recurrence was noted during the entire follow-up period.

Conclusion: Most MCURLs were localized medially to the inner ring of the inguinal canal and could be excised by a TAPP procedure.

Keywords: Mesothelial cyst of uterine round ligament; excision; groin mass; inner ring of inguinal canal; laparoscopic transabdominal preperitoneal procedure; open surgery.