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Elective neurectomy during open, “tension free” inguinal hernia repair

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Abstract

Chronic postoperative inguinal pain syndromes are potentially debilitating sequelae following elective inguinal hernia repair. Diagnosis and definitive treatment constitute challenging issues for both the surgeon and the patient. In this prospective trial, we evaluated the impact of elective iliohypogastric and ilioinguinal nerve resection on the incidence of pain, numbness, and sensory loss following anterior, “tension-free” herniorrhaphy. One hundred ninety-one patients were enrolled and were reviewed 1 month, 6 months, and 1 year postoperatively. Pain, numbness, or any loss of sensation were recorded and categorized on a “mild,” “moderate,” or “severe” scale. No persistent pain syndrome was encountered. Numbness was found in 9.42% of the patients at the first month and in 6.28% of the patients after 1 year. Sensation loss (1.04%) was never bothersome or incapacitating at the end of the follow-up period. Elective neurectomy is safe to perform, well tolerated by patients, and is not associated with chronic postoperative inguinal pain.

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References

  1. Lichtenstein IL (1987) Herniorraphy. A personal experience with 6,321 cases. Am J Surg 153:553–559

    CAS  PubMed  Google Scholar 

  2. Cunningham J, Temple W, Mitchell P, Nixon J, Preshaw R, Hagen N (1996) Cooperative hernia study: Pain in the postrepair patient. Ann Surg 224:598–602

    Article  PubMed  Google Scholar 

  3. Herzog U (1990) Late results following inguinal or femoral hernia surgery. Langenbecks Arch Chir 375:5-10

    CAS  PubMed  Google Scholar 

  4. Moosman DA, Oerlich TM (1977) Prevention of accidental trauma to the ilioinguinal nerve during inguinal herniorrhaphy. Am J Surg 133:146–148

    CAS  PubMed  Google Scholar 

  5. Wantz GE (1984) Complications of inguinal hernia repair. Surg Clin North Am 64:287–298

    PubMed  Google Scholar 

  6. Kehlet H, Bay-Nielsen, Kingsnorth A (2002) Chronic postherniorrhaphy pain-a call for uniform assessment. Hernia 6:178–181

    Article  CAS  PubMed  Google Scholar 

  7. Deysine M, Deysine GR, Reed WP Jr (2002) Groin pain in the absence of hernia: a new syndrome. Hernia 6:64–67

    Article  CAS  PubMed  Google Scholar 

  8. Paajaanen H (2002) Do absorbable mesh sutures cause less pain than nonabsorbable sututres after Lichtenstein inguinal herniorrhaphy? Hernia 6:26–28

    PubMed  Google Scholar 

  9. Dierking GW, Ostergaard E, Ostergaard HT, Dahl JB (1992) Effect of pre- vs postoperative field block on postoperative pain after herniorraphy. Br J Anaesth 68:344–348

    CAS  PubMed  Google Scholar 

  10. Kawi R, Feichter A, Fuchsjager N, Kux M (1999) Postoperative pain and return to activity after five different types of inguinal herniorrhaphy. Hernia 3:31–35

    Google Scholar 

  11. Schmitz R, Shah S, Oerder M, Treckmann J (1999) Does postoperative locally applied second shot analgesia improve the patients’ perception after tension-free hernia repair? A double-blinded study Hernia 3:125–129

    Google Scholar 

  12. Gillion JF, Fagniez PL (1999) Chronic pain and cutaneous sensory changes after inguinal hernia repair: comparison between open and laparoscopic techniques. Hernia 3:75–80

    Google Scholar 

  13. Lau H, Lee F (2001) Determinant factors of pain after ambulatory inguinal herniorraphy: a multi-variate analysis. Hernia 5:17–20

    CAS  PubMed  Google Scholar 

  14. Ravichandran D, Kalambe BG, Pain JA (2000) Pilot randomized controlled study of preservation or division of ilioinguinal nerve in open mesh repair of inguinal hernia. Br J Surg 87:1166–1167

    CAS  PubMed  Google Scholar 

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Correspondence to D. A. Linos.

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Tsakayannis, D.E., Kiriakopoulos, A.C. & Linos, D.A. Elective neurectomy during open, “tension free” inguinal hernia repair. Hernia 8, 67–69 (2004). https://doi.org/10.1007/s10029-003-0175-4

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  • DOI: https://doi.org/10.1007/s10029-003-0175-4

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