Introduction

Inguinal hernia repairs are some of the most performed operations in general surgery worldwide.1 A rare and disconcerting finding during surgical exploration of the inguinal canal is absence of the vas deferens. This finding has been described in up to 1% of inguinal hernia repairs in pediatric patients 2-6, but has not yet been described in inguinal hernia repairs in adult patients. We report the first incidental finding of unilateral absence of the vas deferens during elective laparoscopic totally extraperitoneal (TEP) inguinal hernia repair in an adult patient and describe the postoperative findings and management, clinical relevance, pathophysiology, and make recommendations for management based on literature and our experiences.