Individualized minimally invasive treatment for adult testicular hydrocele: A pilot study

Figure 1 Surgical protocol. A: A 2-cm incision is made in the transverse and anterior skin of the scrotum; B: The sheath cavity is exposed; C: The forefinger of the left hand is used to extend into the sheath cavity to assist the separation and protect the contents of the scrotum from damage; D: The sheath tissue is separated as much as possible until the intended target size is reached; E: The small incision is closed with absorbable sutures; F: The resected sheath tissue is removed and routinely sent for pathological examination.

Figure 2 Diagram of the surgical protocol. A: The maximum diameter of the effusion (d) is measured by preoperative ultrasound; B: The maximum diameter of the sheath that would be peeled off through the small incision is approximately πd/2; C: A sufficient portion of the sheath is removed to prevent recurrence of hydrocele.