Seeing Double: A Rare Encounter with a Duplicate Vas Deferens During Total Extraperitoneal Herniorrhaphy, a Case Report and Review of the Literature.

BACKGROUND: Asymptomatic anatomical anomalies are often found incidentally during unrelated surgical procedures. One rare congenital anomaly, with an incidence of approximately 0.05%, is duplication of the vas deferens within a single spermatic cord, typically identified during hernia repairs or various urological procedures. CASE PRESENTATION: We present the case of a 55-year-old male who underwent a total extraperitoneal laparoscopic herniorrhaphy for a right inguinal hernia. Intraoperatively, two vasa deferentia were identified traversing the deep inguinal ring adjacent to each other. The operation was completed with caution to preserve these structures. The patient had an uncomplicated post-operative course. CONCLUSION: This case underscores the importance of meticulous anatomic identification during inguinal hernia repair. Clinical awareness of such anomalies is essential for avoiding potential surgical complications, including iatrogenic damage to the vas deferens, chronic pain, hematoma, and fistula formation, during inguinal or other urological repairs. This rare case adds to the limited literature on in-surgery recognition of vas deferens duplication.