Prospective study to evaluate the value of Identification of nerves crossing inguinal canal during inguinal mesh hernioplasty

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ayman Abdullah Abdraboh ◽  
Ramy Fouad Hafez ◽  
Mohammed Elsayed Youssef Abozeid
Keyword(s):  
Inguinal Hernia ◽  
Groin Pain ◽  
Open Repair ◽  
Inguinal Canal ◽  
Surgical Techniques ◽  
Inguinal Hernioplasty ◽  
Open Inguinal Hernia Repair ◽  
Nerve Identification ◽  
Mesh Hernioplasty

Abstract Background Long-term morbidity associated with open inguinal hernia repair mainly consists of postoperative chronic pain. The mechanism responsible for the development of this postoperative pain is thought to be the entrapment, inflammation, and fibrotic reactions of the nerve around the mesh. Aim of the Work To analyse and provide comprehensive data on their incidence (identification rates), anatomical characteristics, and possible sources of heterogenecity, to decrease the risk of iatrogenic injury/ entrapment to these nerves during inguinal hernioplasty. Patients and Methods This study identified 40 patients who underwent inguinal hernia repairs with either routine repair or nerve identification and preservation. As several studies point out, a nerve-recognizing procedure is a logical step for minimizing postoperative groin pain. Such an approach can be advocated for two reasons: identification of the nerves for preservation or for performing standard neurectomy in case of interference with the position of the mesh. Results In the present study, there was no difference in pain scorings at one or 3-months after repair between different surgical techniques in patients undergoing open repair of a primary inguinal hernia. In present work, in addition to identifying and preserving all neural structures, specific maneuvers have been adopted for preventing postherniorrhaphy inguinodynia Conclusion The results indicated that routine nerve identification and preservation was associated with a significantly lower incidence of postoperative neuralgia compared with no nerve identification.

scholarly journals A clinical study of the incidence and disability caused by mesh neuralgia after inguinal mesh hernioplasty and the effects of prophylactic ilioinguinal neurectomy and its role in preventing chronic groin pain after inguinal hernioplasty

2018 ◽  
Vol 5 (3) ◽  
pp. 1083
Author(s):  
Samrat Sunkar ◽  
Dick B. S. Brashier ◽  
Kiran Bhagwat ◽  
Vipin Sharma ◽  
Piyush Angrish
Keyword(s):  
Groin Pain ◽  
Sensory Loss ◽  
Chronic Groin Pain ◽  
Inguinal Hernioplasty ◽  
Nerve Preservation ◽  
Pain Disability ◽  
Group A ◽  
Group B ◽  
Mesh Hernioplasty

Background: Residual neuralgia, called as Inguinodynia, is an important complication unique to groin hernia repair. The reported incidence ranges between 9-63%. The symptoms are potentially disabling. Symptoms are often more pronounced on axial twisting of body. Methods for prevention include identification and preservation of all nerves, Ilioinguinal Neurectomy and triple Neurectomy during surgery.Methods: One hundred patients underwent elective unilateral Lichtenstein’s tension free hernioplasty. 50 patients were subjected to elective ilioinguinal neurectomy. The remaining underwent standard Liechtenstein’s mesh hernioplasty, without ilioinguinal neurectomy. Randomization was achieved by allocating alternate patients to each group - prophylactic neurectomy, or nerve preservation. All patients, during each review were asked to fill out a Pain Disability Questionnaire to assess sensory loss and pain disability objectively.Results: At completion of 6 monthly follow up pain at rest (none in group ‘A’ compared with 3 in group ‘B’), after coughing 5 times (none in group ‘A’ compared with 7 in group ‘B’), after climbing 4 flights of stairs(3 in group ‘A’ compared with 16 in group ‘B’) and after cycling for 20 minutes (11 in group ‘A’ compared with 22 in group ‘B’) were all significantly lesser in the neurectomy group as compared with the non neurectomy group. More importantly, exertional chronic pain incidence at 6 months was significantly less in group ‘A’.Conclusions: It was concluded that pain after inguinal mesh hernioplasty is a cause of morbidity, pain was complained of by a significantly larger number of non-neurectomised patients at 6 months of follow-up, prophylactic ilioinguinal neurectomy is associated with reduced exertional chronic groin pain, disability caused by pain after inguinal hernioplasty, is significantly reduced by ilioinguinal neurectomy and an extremely significant reduction in the requirement of medication is brought about by neurectomy compared with controls. 

Short- and long-term outcomes of open inguinal hernia repair: comparison of the Prolene Hernia System and the Mesh Plug method

Surgery Today ◽  
2014 ◽  
Vol 44 (12) ◽  
pp. 2255-2262 ◽  
Author(s):  
Yuki Hayashi ◽  
Kanji Miyata ◽  
Norihiro Yuasa ◽  
Eiji Takeuchi ◽  
Yasutomo Goto ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Mesh Plug ◽  
Long Term Outcomes ◽  
Prolene Hernia System ◽  
Open Inguinal Hernia Repair ◽  
Short And Long Term

scholarly journals The results of preperitoneal inguinal hernioplasty without fixation of the mesh endoprosthesis in the experiment.

2019 ◽  
Vol 12 (2) ◽  
pp. 97-101
Author(s):  
Anna Viktorovna Mokrova ◽  
Oleg Vladimirovich Zaitsev ◽  
Dmitry Anatolyevich Khubezov ◽  
Vladimir Alexandrovich Yudin ◽  
Sergey Vasilevich Tarasenko ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Inguinal Canal ◽  
Abdominal Cavity ◽  
Preperitoneal Space ◽  
Indirect Inguinal Hernia ◽  
Inguinal Hernioplasty ◽  
Experimental Development ◽  
Direct Inguinal Hernia ◽  
Significant Difference ◽  
Mesh Endoprosthesis

The purpose of the study is experimental development of preperitoneal inguinal hernioplasty with synthetic mesh, according assessment of the need of its fixation to the tissues. Materials and methods. An inguinal hernia was simulated on human cadaveric material. The study used 27 male corpses. Two inguinal hernias were modeled on one corpse: on one side - indirect, on the other - direct. A polypropylene mesh (standard density, 15 x 15 cm) was placed in the preperitoneal space. The endoprosthesis was impacted from the side of the abdominal cavity by a special designed device. The effect of a peak intra-abdominal pressure of 200 mm Hg was simulated. The degree of displacement of the reticular endoprosthesis into the inguinal canal was estimated at the moment of peak pressure on it from inside the abdominal cavity. For a simulated indirect inguinal hernia, two variants of the technique were considered: with fixation of the endoprosthesis to the underlying tissues and without fixation. For the modulated direct inguinal hernia, the following options were considered: non-fixative, with fixation at one point to the pubis and with plasty of the transverse fascia. Results. When modeling preperitoneal plasty of a direct inguinal hernia, there is a pronounced displacement of the endoprosthesis into the inguinal canal with a non-fixing plasty, unlike the method with transverse fascia plasty or fixation to the pubis. In indirect inguinal hernia, there was no significant displacement of the endoprosthesis in both considered variants. Conclusions. According to the obtained results, conclusions were drawn on the need for additional plasty of the transverse fascia or fixation of the endoprosthesis at a single point in a direct inguinal hernia. With indirect inguinal hernia in the experiment, no significant difference in the displacement of the mesh endoprosthesis into the inguinal canal was obtained with and without fixation.

scholarly journals Prolene Hernia System Herniorraphy Versus Open Inguinal Hernia Repair by Lichtenstein Tension Free Mesh Hernioplasty -A Randomized Study

2020 ◽  
Vol 5 (8) ◽  
pp. 729-733
Author(s):  
Dr. Kunal Malhotra ◽  
Dr. Tushar Aggarwal ◽  
Dr. Subhash Sharma ◽  
Dr. Anil Malhotra
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Operative Time ◽  
Randomized Study ◽  
Tension Free ◽  
Prolene Hernia System ◽  
Operative Complications ◽  
Open Inguinal Hernia Repair ◽  
Mesh Hernioplasty

Prolene Hernia System is a tension free anterior inguinal hernia repair using a bilayered modification of inguinal hernia mesh. Inguinal hernia repair by Prolene is comparable with almost equal operating time, smaller incision and with a trend towards decreased complications rate and reduced rate of recurrences. This study was conducted to study and to compare the results of Prolene Hernia System and Lichtenstein Tension Free mesh hernioplasty with respect to its operative time, post-operative pain, intra/post-operative complications and total hospital stay. The effectiveness of PHS were compared to Lichtenstein tension free mesh hernias repair in patients presenting with uncomplicated Inguinal Hernia for elective surgery in the Surgery department of IGMC, Shimla. Duration of surgery was shorter in Prolene Hernia System group (p=0.04) than the Lichtenstein tension free mesh hernioplasty [32 vs 34 minutes], The mean pain intensity in present study was 2.9 in Lichtenstein tension free mesh hernioplasty group and 2.7 in Prolene Hernia System, No intra-operative complications were seen with either of the two groups. Post-operative complications in the form of Seroma formation were more in Lichtenstein tension free mesh hernioplasty group than Prolene Hernia System group (8 vs 0). There were two cases of recurrence in the Lichtenstein tension free mesh hernioplasty group, while no short-term recurrence was seen in Prolene Hernia System group over 12 weeks. Mean duration of post-operative hospital stay was 1.57 days for Lichtenstein tension free mesh hernioplasty group and 1.33 days for Prolene Hernia System group. This study concludes that even though the difference between the two methods in this randomized study were small, the Prolene Hernia System repair method for open inguinal hernia repair was associated with a shorter operative time, lower rate of recurrence, as well as fewer complications when compared with the Lichtenstein tension free mesh hernioplasty. Further prospective studies are needed to rigorously evaluate the comparative advantages of Prolene Hernia System repair in relation to other repair methods

scholarly journals Ilioinguinal neurectomy in open inguinal hernia mesh repair

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Muhammad Khalid Naseem Mirza ◽  
Fakhar Hameed ◽  
Muhammad Sajid Sheikh ◽  
Mustehsan Bashir
Keyword(s):  
Inguinal Hernia ◽  
Descriptive Study ◽  
Inguinal Hernioplasty ◽  
Hernia Mesh ◽  
Unilateral Inguinal Hernia ◽  
Design Case ◽  
Long Term Impact ◽  
Hernia Mesh Repair

Objectives: To evaluate the long-term impact of ilioinguinal neurectomy on the incidence of postoperative neuralgia and paraesthesia following the tension free Lichtenstein`s hernia repair. Study design: Case Descriptive Study. Place and duration of study: DHQ Hospital, Faisalabad (January 2003 - January 2005). Patients and methods: A total of 200 patients having unilateral inguinal hernia were included in the study. After a detailed history, patients were subjected to standard Lichtenstein inguinal hernioplasty. All patients underwent elective ilioinguinal neurectomy at the time of hernioplasty. Postoperative pain and paraesthesia were recorded and categorized on a mild, moderate or severe scale. Patients were followed 1 month, 6month and 1 year postoperatively. Results: The incidence of chronic pain was 9% at 1 month & 6% at 6 months and 1 year postoperatively. None of the patients developed severe persistent pain in inguinal region. The incidence of post operative paraesthesia showed a continuous decli ne. It was 32% at 1 month, 24% at 6 month and 19% at 1 year of follow up. The paraesthesia was never severe or bothersome at the end of the follow up period. Conclusion:Routine ilioinguinal neurectomy significantly reduces the chronic post-hernioplasty inguinal pain. Moreover it is safe to perform & well tolerated by the patients.

Sign in / Sign up

Export Citation Format

Share Document