Introduction: A hydrocele of the canal of Nuck is an exceedingly rare condition. Reports describing its treatment have almost exclusively involved open surgery. Advancements in minimally-invasive techniques have allowed us to employ laparoscopic hernia repair methods as a novel way of treating this condition.
Case Report: We present a 50-year-old obese female who was diagnosed with a 4.2x3.2 cm encysted hydrocele of the canal of Nuck on computed tomography. This arose from the peritoneal cavity in association with the left uterine round ligament and extended towards the left labia majora. The hydrocele was approached using a standard transabdominal preperitoneal technique. After dissecting the hydrocele from the canal, it was further parietalized along with its associated round ligament, which was then ligated and divided. A prolene mesh was used to cover the resultant defect in the internal inguinal ring. The peritoneal flap was repositioned and the peritoneal defect traversed by the round ligament was closed intracorporeally with an absorbable suture. The patient made an uneventful recovery and was discharged the next day.
Conclusion: Transabdominal preperitoneal approach allows for adequate assessment and complete excision of the canal of Nuck cyst, while combining the benefits of minimally-invasive tension-free mesh repair.

Keywords: Canal of Nuck, Hydrocele, Transabdominal preperitoneal mesh repair