The efficacy of the conventional surgical techniques in the treatment of simple hydrocele has been well-established. However, further insights into the embryological anatomy of the testis and its layers have led to the development of new surgical concepts. We have conducted a retrospective study after using an "avascular" technique (extravaginalization-marsupialization) with optimum results. 120 patients treated by the Wilkinson vaginal reversal were assessed for efficacy and complications. The working hypothesis and the principles based on embryological anatomy are discussed. The results and relevant data of the treated group of patients are presented.