From a Presumed Indirect Inguinal Hernia to a Confirmed Saddlebag Hernia: The Diagnostic Value of Laparoscopy

Inguinal hernia repair is one of the most frequently performed procedures in general surgery. Over recent decades, surgical management has evolved from tissue-based repairs to tension-free mesh techniques and, more recently, to minimally invasive approaches such as laparoscopy, which have demonstrated advantages in terms of postoperative pain, hospital stay, and recovery time.We report the case of a 36-year-old man with a presumed right indirect inguinal hernia evolving for two years. A laparoscopic approach using the TAPP technique was chosen. Intraoperative exploration revealed a combined direct and indirect inguinal hernia, also known as a saddlebag (pantaloon) hernia. A polypropylene mesh was placed in the preperitoneal space without intraoperative complications. Postoperative recovery was uneventful, with no recurrence or complications during follow-up.Laparoscopy plays a crucial diagnostic and therapeutic role in inguinal hernia surgery. It allows accurate identification of complex hernia types that may be underestimated on clinical examination and enables optimal mesh placement with favorable postoperative outcomes.