Planned ilioinguinal nerve excision for prevention of chronic pain after inguinal hernia repair: A meta-analysis

Surgery ◽  
2011 ◽  
Vol 150 (3) ◽  
pp. 534-541 ◽  
Author(s):  
Amanda Johner ◽  
Jason Faulds ◽  
Sam M. Wiseman
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Meta Analysis ◽  
Ilioinguinal Nerve ◽  
Prevention Of Chronic Pain

scholarly journals Risk factors of chronic pain after inguinal hernia repair: a systematic review

2017 ◽  
Vol 2 (2) ◽  
pp. 61-68 ◽  
Author(s):  
Wolfgang Reinpold
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Pain Intensity ◽  
Inguinal Hernia Repair ◽  
Daily Activities ◽  
Detailed Knowledge ◽  
Ilioinguinal Nerve

AbstractIntroduction:Chronic postoperative inguinal pain (CPIP) is the most common complication after inguinal hernia operation. Eighteen percent (range, 0.7%–75%) of patients suffered from CPIP after open inguinal hernia repair and 6% (range, 1%–16%) reported CPIP after laparoendoscopic groin hernia repair. The incidence of clinically significant CPIP with impact on daily activities ranged between 10% and 12%. Debilitating CPIP with severe impact on normal daily activities or work was reported in 0.5%–6% of the cases.Materials and methods:PubMed, Medline, Embase, and the Cochrane Database were searched for studies on risk factors for chronic pain after open and endoscopic hernia repair. A systematic review of the literature was conducted using the grading of recommendations, assessment, development, and evaluations (GRADE) methodology.Results:Risk factors for CPIP with strong evidence include female gender, young age, high intensity of preoperative pain, high early postoperative pain intensity, history of chronic pain other than CPIP, operation for a recurrent hernia, and open repair technique. Risk factors for CPIP with moderate evidence include postoperative complications, neurolysis, and preservation of the ilioinguinal nerve in Lichtenstein repair. Risk factors for CPIP with low evidence include genetic predisposition (DQB1*03:02 HLA haplotype), lower preoperative optimism, high pain intensity to tonic heat stimulation, inadequate suture/staple/clip mesh fixation, ignorance of the inguinal nerves, less experienced surgeon, sensory dysfunction in the groin, and worker’s compensation.Conclusion:Detailed knowledge of the risk factors, meticulous operative technique with profound knowledge of the anatomy, proper nerve identification and handling, optimization of prosthetic materials, and careful fixation are of utmost importance for the prevention of CPIP.

scholarly journals Ilioinguinal Nerve Neurectomy is better than Preservation in Lichtenstein Hernia Repair: A Systematic Literature Review and Meta-analysis

2021 ◽  
Author(s):  
Roberto Cirocchi ◽  
Marco Sutera ◽  
Piergiorgio Fedeli ◽  
Gabriele Anania ◽  
Piero Covarelli ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Groin Pain ◽  
Meta Analysis ◽  
Group Versus ◽  
Chronic Groin Pain ◽  
Ilioinguinal Nerve ◽  
Nerve Preservation ◽  
Lichtenstein Hernia Repair

Abstract Objective This study aimed to evaluate the incidence of chronic groin pain (primary outcome) and alterations of sensitivity (secondary outcome) after Lichtenstein inguinal hernia repair, comparing neurectomy with ilioinguinal nerve preservation surgery. Summary background data The exact cause of chronic groin postoperative pain after mesh inguinal hernia repair is usually unclear. Section of the ilioinguinal nerve (neurectomy) may reduce postoperative chronic pain. Methods We followed PRISMA guidelines to identify randomized studies reporting comparative outcomes of neurectomy versus ilioinguinal nerve preservation surgery during Lichtenstein hernia repairs. Studies were identified by searching in PubMed, Scopus, and Web of Science from April 2020. The protocol for this systematic review and meta-analysis was submitted and accepted from PROSPERO: CRD420201610. Results In this systematic review and meta-analysis, 16 RCTs were included and 1550 patients were evaluated: 756 patients underwent neurectomy (neurectomy group) vs 794 patients underwent ilioinguinal nerve preservation surgery (nerve preservation group). All included studies analyzed Lichtenstein hernia repair. The majority of the new studies and data comes from a relatively narrow geographic region; other bias of this meta-analysis is the suitability of pooling data for many of these studies. A statistically significant percentage of patients with prosthetic inguinal hernia repair had reduced groin pain at 6 months after surgery at 8.94% (38/425) in the neurectomy group versus 25.11% (113/450) in the nerve preservation group [relative risk (RR) 0.39, 95% confidence interval (CI) 0.28–0.54; Z = 5.60 (P < 0.00001)]. Neurectomy did not significantly increase the groin paresthesia 6 months after surgery at 8.5% (30/353) in the neurectomy group versus 4.5% (17/373) in the nerve preservation group [RR 1.62, 95% CI 0.94–2.80; Z = 1.74 (P = 0.08)]. At 12 months after surgery, there is no advantage of neurectomy over chronic groin pain; no significant differences were found in the 12-month postoperative groin pain rate at 9% (9/100) in the neurectomy group versus 17.85% (20/112) in the inguinal nerve preservation group [RR 0.50, 95% CI 0.24–1.05; Z = 1.83 (P = 0.07)]. One study (115 patients) reported data about paresthesia at 12 months after surgery (7.27%, 4/55 in neurectomy group vs. 5%, 3/60 in nerve preservation group) and results were not significantly different between the two groups [RR 1.45, 95% CI 0.34, 6.21;Z = 0.51 (P = 0.61)]. The subgroup analysis of the studies that identified the IIN showed a significant reduction of the 6th month evaluation of pain in both groups and confirmed the same trend in favor of neurectomy reported in the previous overall analysis: statistically significant reduction of pain 6 months after surgery at 3.79% (6/158) in the neurectomy group versus 14.6% (26/178) in the nerve preservation group [RR 0.28, 95% CI 0.13–0.63; Z = 3.10 (P = 0.002)]. Conclusion Ilioinguinal nerve identification in Lichtenstein inguinal hernia repair is the fundamental step to reduce or avoid postoperative pain. Prophylactic ilioinguinal nerve neurectomy seems to offer some advantages concerning pain in the first 6th month postoperative period, although it might be possible that the small number of cases contributed to the insignificancy regarding paresthesia and hypoesthesia. Nowadays, prudent surgeons should discuss with patients and their families the uncertain benefits and the potential risks of neurectomy before performing the hernioplasty.

scholarly journals Robotic inguinal hernia repair: systematic review and meta‐analysis

2021 ◽  
Author(s):  
Amjad Qabbani ◽  
Omar M. Aboumarzouk ◽  
Tamer ElBakry ◽  
Abdulla Al‐Ansari ◽  
Mohamed S. Elakkad
Keyword(s):  
Systematic Review ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Meta Analysis ◽  
Robotic Inguinal Hernia Repair

Inguinal Hernia Repair Using Self-adhering Sutureless Mesh: Adhesix™: A 3-Year Follow-up with Low Chronic Pain and Recurrence Rate

2016 ◽  
Vol 82 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Malek Tabbara ◽  
Laurent Genser ◽  
Manuela Bossi ◽  
Maxime Barat ◽  
Claude Polliand ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Postoperative Complications ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Recurrence Rate ◽  
Initial Surgery ◽  
Complications Rate

To review our experience and outcomes after inguinal hernia repair using the lightweight self-adhering sutureless mesh “Adhesix™” and demonstrate the safety and efficacy of this mesh. This is a 3-year retrospective study that included 143 consecutive patients who underwent 149 inguinal hernia repairs at our department of surgery. All hernias were repaired using a modified Lichtenstein technique. Preoperative, perioperative, and postoperative data were prospectively collected. Incidence of chronic pain, postoperative complications, recurrence, and patient satisfaction were assessed three years postoperatively by conducting a telephone survey. We had 143 patients with a mean age of 58 years (17–84), who underwent 149 hernia repairs using the Adhesix™ mesh. Ninety-two per cent (131 patients) were males. Only 10 patients (7%) had a postoperative pain for more than three years. In our series, neither age nor gender was predictive of postoperative pain. Only one patient had a hematoma lasting for more than one month and only four patients (2.8%) had a recurrence of their hernia within three years of their initial surgery. Ninety per cent of the patient expressed their satisfaction when surveyed three years after their surgery. In conclusion, the use of the self-adhering sutureless mesh for inguinal hernia repair has been proving itself as effective as the traditional mesh. Adhesix™ is associated with low chronic pain rate, recurrence rate, and postoperative complications rate, and can be safely adopted as the sole technique for inguinal hernia repair.

Chronic pain following elective inguinal hernia repair—is it a common clinical problem?

2007 ◽  
Vol 32 (Suppl. 1) ◽  
pp. 174
Author(s):  
Z. M. Kirkor ◽  
T. N. Evans ◽  
H. Mathew ◽  
C. Swart ◽  
C. Morris ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Clinical Problem ◽  
Common Clinical Problem

scholarly journals Large retroperitoneal haematoma: an unexpected complication of ilioinguinal nerve block for inguinal hernia repair

Anaesthesia ◽  
2011 ◽  
Vol 67 (1) ◽  
pp. 80-81 ◽  
Author(s):  
M. A. Parvaiz ◽  
V. Korwar ◽  
D. McArthur ◽  
A. Claxton ◽  
J. Dyer ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Nerve Block ◽  
Ilioinguinal Nerve ◽  
Retroperitoneal Haematoma
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