Sensory disturbances and neuropathic pain after inguinal hernia surgery

2010 ◽  
Vol 1 (2) ◽  
pp. 108-111 ◽  
Author(s):  
Niklas Magnusson ◽  
Mats Hedberg ◽  
Johanna Österberg ◽  
Gabriel Sandblom
Keyword(s):  
Inguinal Hernia ◽  
Hernia Surgery ◽  
Ilioinguinal Nerve ◽  
Tep Repair ◽  
Anaesthetic Agents ◽  
Inguinal Hernia Surgery ◽  
Total Extraperitoneal ◽  
Sensory Disturbances ◽  
One Year ◽  
Pain Descriptors

AbstractObjectivesThe aim of this study was to explore how the handling of nerves affects the risk for developing sensory disturbances (SDs) following groin hernia surgery.Patients and methodsAll patients 18 years or older undergoing surgery for inguinal hernia at Mora Hospital, Sweden, during an eight-month period in 2006, were eligible for inclusion. The surgical procedure was recorded prospectively according to a standardised protocol. One year postoperatively all patients were requested to answer the Inguinal Pain Questionnaire as well as a set of 18 sensory and affective pain descriptors. They were also invited to clinical examination including sensory testing.ResultsOf the 157 hernia repairs in Mora during the period of study, 128 repairs in 116 patients, were registered prospectively according to the study protocol. Laparoscopic total extraperitoneal (TEP) repair was performed in 36 (28%) of the patients. Ninety-two (79%) patients, including five patients operated bilaterally, underwent postoperative examination. SDs were found in 33 (34%) of the groins examined. No descriptor was found that significantly predicted the presence of altered examination findings. No significant association between the intraoperative handling of nerves and SD was seen. In the TEP-group, no SDs were seen. Infiltration of local anaesthetic agents and blockade of the ilioinguinal nerve prior to surgery were found to be significantly associated with SD more than 2 cm away from the scar (both p < 0.05). The presence of SD was not associated with significant pain.ConclusionsSDs are common after open hernia surgery, but are not associated with persistent postoperative pain.

scholarly journals Total extraperitoneal approach in large inguino-scrotal hernias: an institutional approach

2016 ◽  
Vol 18 (3) ◽  
pp. 51 ◽  
Author(s):  
Tuhin Shah ◽  
S Shah ◽  
BR Joshi ◽  
RJ Karkee ◽  
RK Gupta
Keyword(s):  
Inguinal Hernia ◽  
Operating Time ◽  
Operation Time ◽  
Hernia Surgery ◽  
Recurrence Rates ◽  
Hernia Sac ◽  
Tep Repair ◽  
Inguinal Hernia Surgery ◽  
Total Extraperitoneal ◽  
The Mean

Introduction: Since 2 decades laparoscopichernia repair has gained key role in uncomplicated inguinal hernia surgery with advantages showed by several trials and guidelines. However, its role in complicated inguinal hernia such as incarcerated, obstructed and inguino-scrotal is debatable. Cases of large inguino-scrotal raises objection to laparoscopic procedure because of anticipated problems and complications in dissecting extended hernia sac even though posterior approach is advocated as repair of choice for complicated cases. Here, we reviewed our series of patients undergoing TEP in a limited time frame.Method: Between March 2013 and June 2014, 50 consecutive patients underwent TEP repair for inguinoscrotal hernia. Patient demographics, hernia characteristics, operating time, surgical technique, conversion rate, intraoperative, postoperative complications and recurrence was recorded and analyzed using MS Excel.Results: 50 patients were recorded, 26 had unilateral and 24 had bilateral hernias. Mean age was 52 (22-72) years. The mean operation time was 70 (50-140) min. Bilateral repairs took 45% (18 min) longer than for unilateral repairs (52 + 12 min). Two (12.5%) patients required combined open surgery to transect the incarcerated omentum. There was no mortality. Morbidity was limited to asymptomatic seroma formation in 2 (12.5%) patients; 1 patient of combined open-TEP approach had wound infection, both treated conservatively. Mean follow up was 6.3 months; we recorded 2 recurrences (12.5%). The mean length of hospital stay was 1.8 days.Conclusion: We conclude that TEP can be safely employed for complicated inguinal hernias repair. Surgical experience in mandatory with tailored technique to reduce morbidity and achieve good clinical outcome with acceptable recurrence rates.

scholarly journals The inguinal hernia management in Costa Rica according to a survey between surgeons: result comparison with 2018 International Groin Hernia Guidelines

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jesús Martínez-Hoed ◽  
Katherine Cordero-Bermúdez ◽  
Providencia García-Pastor ◽  
Salvador Pous-Serrano ◽  
José A. Ortiz-Cubero
Keyword(s):  
Inguinal Hernia ◽  
Costa Rica ◽  
Groin Hernia ◽  
Laparoscopic Approach ◽  
Costa Rican ◽  
International Guideline ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery ◽  
General Surgeons ◽  
One Year

Abstract Background Inguinal hernia surgery is a frequent procedure among general surgeons in Costa Rica, but the management and technique are not uniform. The International Guideline for Groin Hernia management was published in 2018 to standardize the inguinal hernia surgery, but the diffusion of the guidelines and its adherence have been extremely varied. Purpose Collect and analyze the current reality regarding groin hernia management in Costa Rica. Secondly evaluate the diffusion and development comparing it to the guideline’s recommendations. Method Questionnaire of 42 single and multiple answer questions according to the topics of the International Guideline directed to general surgeons. Diffusion of the inquiry through surgical and hernia association chats and email. Timeframe June–December 2019. Results 64 surveys were collected, which is a representative number of the general surgeons national college. The most frequent procedure between these was the abdominal wall surgery. Every surgeon did more than 52 groin hernia surgeries in one year, most of them outpatients. The epidural anesthesia was used the most and Lichtenstein’s technique was the most frequently used (64%). 68% of the surgeons know how to perform a minimally invasive inguinal hernia surgery but with variable volumes. 38% of participants considered themselves experts in groin hernia management and 52% did not know the 2018 International Guideline. The recommendations of such guideline are followed only partially. Conclusions The 2018 Hernia Surge International Guidelines have low diffusion among Costa Rican surgeons. The laparoscopic approach is widely accepted but there are no studies to assess the results and the quality. There should be protocols and studies adapted to Costa Rica’s national situation.

scholarly journals Chronic Post-Inguinal Herniorrhaphy Pain in a Setting in Rural Africa

2021 ◽  
pp. 53-58
Author(s):  
Richard Wismayer
Keyword(s):  
Inguinal Hernia ◽  
Groin Pain ◽  
Hospital Setting ◽  
Chronic Groin Pain ◽  
Hernia Surgery ◽  
Ilioinguinal Nerve ◽  
Male Predominance ◽  
Inguinal Hernia Surgery ◽  
Routine Identification ◽  
Rural Africa

Introduction: In Africa, inguinal hernia is a common surgical condition with an incidence of 175 inguinal hernias per 100,000 people each year. Pain that persists for at least a duration of 3 months postoperatively following repair of an inguinal hernia defines chronic groin pain. The objective of this study was to determine the prevalence of chronic groin pain in a group of patients in a hospital setting in rural Africa. Methodology: A descriptive retrospective study was carried out between 1st April 2008 to the 31st July 2012 on all patients ≥15 years of age that underwent an inguinal hernia repair were eligible in this study. Data was retrieved from patients’ clinical notes and theatre log books on age, sex, recurrence of hernia and post-operative pain lasting at least 3 months. Data obtained in the interview questionnaire included duration of pain, pain at the operation site, type of postoperative analgesia and a physical examination to determine recurrence was performed in the surgical-out-patients clinic. Results: One hundred and fifty eight patients following repair of inguinal hernia using the modified Bassini technique were analysed. Mean age was 44.84 years. The male:female ratio was 3.65:1 with a male predominance. Chronic groin pain/discomfort was reported in 22(13.92%) and this pain/discomfort lasted for at least 3 months post-operatively. Conclusions: The low incidence of chronic groin pain in our study may be due to the majority of them being operated as elective procedures under local anaesthesia with routine identification of the ilioinguinal nerve. However, a study with a larger sample size and a longer follow up may be required to ascertain the true prevalence of chronic groin pain following inguinal hernia surgery in rural Africa.

scholarly journals Paediatric Day Care Inguinal Hernia Surgery in a General Hospital: A Prospective Study on Change in Practice

1970 ◽  
Vol 30 (3) ◽  
pp. 128-131 ◽  
Author(s):  
JN Shah ◽  
N Subedi
Keyword(s):  
Inguinal Hernia ◽  
Prospective Study ◽  
General Hospital ◽  
Day Care ◽  
General Surgeon ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery ◽  
Routine Work ◽  
One Year ◽  
A Prospective Study

Introduction: This prospective study was undertaken to observe the prospects of daycare inguinal hernia surgery in general hospital setup in a developing country like Nepal and to assess the advantages, acceptability and safety of this approach. Methodology: The study was carried out prospectively for one year from March 2009- Feb 2010. Before surgery, children were examined in surgical referral clinic (SRC). Parents were given verbal and written instructions for pre-operative fasting. Operations were carried out under intravenous anesthesia without intubation by experienced consultant general surgeon or by registrar under supervision. Children were observed in recovery area till conscious. Once awake, the children were handed over to parents for further observation till fully conscious and could tolerate liquid. Oral Paracetamol and homecare instructions were given to parents. Appointment slip was given for follow up visit in SRC within 3-5 days. Results: There were 90 children, male 81 (89%), age 2 months to 13 years. Right inguinal hernias were 62 (70%). There were no major complications, mortality or readmission. Saving in terms of less disruption of routine work at home and office was more appreciated by parents. Conclusion: We conclude that day care inguinal hernia surgery in children in our setup is safe, economic well accepted by child and parent's both. Key words: Children; Day case hernia surgery; Paediatric inguinal hernia DOI: 10.3126/jnps.v30i3.3913J Nep Paedtr Soc 2010;30(3):128-131

scholarly journals Perioperative Platelet Inhibition in Elective Inguinal Hernia Surgery—Increased Rate of Postoperative Bleeding and Hematomas?

2019 ◽  
Vol 103 (1-2) ◽  
pp. 40-47
Author(s):  
Lucas D. Lee ◽  
Gerrit zur Hausen ◽  
Katja Aschenbrenner ◽  
Andrea Stroux ◽  
Martin E. Kreis ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Antiplatelet Therapy ◽  
Postoperative Bleeding ◽  
Platelet Inhibition ◽  
Hernia Surgery ◽  
Antithrombotic Prophylaxis ◽  
Postoperative Hematoma ◽  
Inguinal Hernia Surgery ◽  
Total Extraperitoneal

In patients on oral antiplatelet therapy secondary to critical vascular diseases, the risk of interrupting antiplatelet therapy has to be weighed against the risk of postoperative hematoma or bleeding when surgery is planned. The goal of this study was to determine the risk of postoperative hematoma and postoperative bleeding in elective inguinal hernia surgery during continuous platelet inhibition. Patients receiving either elective total extraperitoneal hernioplasty or Lichtenstein repair for inguinal hernia were included. Patients with mere suture repair, emergency hernia repair, combination of different simultaneous operations, and patients under therapeutic anticoagulation with heparin were excluded. Postoperative bleeding/hematoma was determined by physical examination and graded according to the Clavien-Dindo classification. Between January 2006 and December 2013, 561 patients with elective surgical repair of an inguinal hernia were included. A total of 29 patients were under continuous perioperative platelet inhibition (PI) with either aspirin or clopidogrel in addition to perioperative antithrombotic prophylaxis with subcutaneous dalteparin injections (PI group). A total of 532 patients received perioperative antithrombotic prophylaxis only (control group). The number of patients under antiplatelet therapy increased from 1.3% (Jan. 2006–Dec. 2009) to 10.0% (Jan. 2010–Dec. 2013; P &lt; 0.0001). Postoperative hematoma/bleeding occurred in 5 PI patients (17.2%) versus 38 control patients (7.1%, P = 0.062). Rate of postoperative bleeding or hematoma is not higher under mono antiplatelet therapy for elective inguinal hernia repair. Since the majority of hematomas can be treated conservatively, it seems unnecessary to stop mono platelet inhibition perioperatively.

scholarly journals Inguinal hernia repair: can one identify the three main nerves of the region?

2015 ◽  
Vol 42 (3) ◽  
pp. 149-153 ◽  
Author(s):  
João Vicente Machado Grossi ◽  
Leandro Totti Cavazzola ◽  
Ricardo Breigeiron
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Randomized Study ◽  
Operating Time ◽  
Hernia Surgery ◽  
Nerve Branch ◽  
Ilioinguinal Nerve ◽  
Inguinal Hernia Surgery ◽  
The Right

<sec><title>OBJECTIVE:</title><p> To identify the nerves in the groin during inguinal hernia repair by inguinotomy.</p></sec><sec><title>METHODS:</title><p> We conducted a prospective, sequenced, non-randomized study comprising 38 patients undergoing inguinal hernia repair with placement of polypropylene mesh.</p></sec><sec><title>RESULTS:</title><p> The male patients were 36 (94.7%), with a mean age and standard deviation of 43.1 ± 14.5, body mass index of 24.4 ± 2.8. Comorbidities were hypertension in two (5.2%), smoking in 12 (31.5%) and obesity in two (5.2%). The hernia was located only on the right in 21 (55.2%) patients, only on the left in 11 (28.9%), and was bilateral in six (15.7%) patients. Prior hernia repair was present in seven (18.4%) patients. The identification of the three nerves during operation was made in 20 (52.6%) patients, the ilioinguinal nerve and the iliohypogastric nerve were identified in 33 (86.8%), and the genital nerve branch of the genitofemoral nerve, in 20 (52.6%). Resection of at least one of the nerves was performed in seven (18.4%) cases, two iliohypogastric nerves and five ilioinguinal nerves. The average operating time was 70.8 ± 18.2 minutes. The hospital stay was 1.42 ± 1.18 days. Ten patients (26.3%) returned to physical activity around the first postoperative visit, and 37 (97.3%) in the last. The follow-up time was 95.6 ± 23.5 days. The inability to identify the ilioinguinal nerve was associated with previous repair (p = 0.035).</p></sec><sec><title>CONCLUSION:</title><p> The identification of the three nerves during inguinal hernia surgery has been described in more than half of the cases and prior repair interfered with the identification of ilioinguinal nerve.</p></sec>

New Four-fold Technique to Spread the Self-Gripping Mesh in Open Inguinal Hernia Surgery

2021 ◽  
Author(s):  
Arun Kumar Gupta ◽  
Aman Raj ◽  
Devadatta Poddar ◽  
Lalit Kumar Bansal ◽  
Peeyush Kumar ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
The Self ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery
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