scholarly journals A prospective study comparing preservation of ilioinguinal nerve with neurectomy in open mesh repair of inguinal hernia

2018 ◽  
Vol 6 (1) ◽  
pp. 114
Author(s):  
Probal Neogi ◽  
Santosh Kumar Singh ◽  
Soumitra Manwatkar ◽  
Sunil Kumar Singh ◽  
Abhishek Saxena ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Mesh Repair ◽  
Groin Pain ◽  
Chronic Groin Pain ◽  
Ilioinguinal Nerve ◽  
Open Mesh Repair ◽  
The Difference ◽  
A Prospective Study ◽  
Open Mesh

Background: Postoperative pain after open mesh repair of inguinal hernia is an important challenge. Such type of pain sometimes does not respond to medical treatment including non-steroidal anti-inflammatory drugs and opiates. The objective of the present study was to evaluate the effect of preservation or division of the Ilioinguinal nerve on pain and post-operative symptoms, after open mesh repair of inguinal hernia.Methods: All patients undergoing surgery for tension free Lichtenstein mesh repair over a period of 1 year were included. Patients below the age of 18 years and patients with bilateral or recurrent hernias were excluded.Results: In present study of 42 patients, early mean postoperative pain at day 1 was 1.8 on VAS scale in ilioinguinal neurectomised patient compared to 1.5 in nerve preserved group (P=0.1408). Postoperative pain at week 1 was 1.25 in neurectomised patients compared to 1.32 in nerve preserved group (P=0.7161). Late Postoperative pain and chronic groin pain was 0.6 and 0.25 at 1 and 3 months respectively in ilioinguinal neurectomised patients as compared to 1.05 and 0.77 at 1 and 3 months respectively in nerve preserved group (P=0.0184 at 1month and P=0.0335 at 3 months).Conclusions: The difference in postoperative pain at day 1 and at week 1 was not significant and both groups had equal pain. Late postoperative pain (at 1 month) and chronic groin pain (at 3 months) was significantly low in ilioinguinal neurectomised patient compared to nerve preserved group.

scholarly journals Prophylactic ilioinguinal neurectomy: Can it prevent chronic groin pain after Lichtenstein inguinal hernia repair?

2016 ◽  
Vol 4 (2) ◽  
pp. 39-44 ◽  
Author(s):  
Arbin Joshi
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Groin Pain ◽  
Chronic Groin Pain ◽  
Ilioinguinal Nerve ◽  
Nerve Preservation ◽  
Medical College ◽  
Open Mesh Repair

Background: Contrary to the previous belief, division of the ilioinguinal nerve prophylactically during mesh repair has been practiced to reduce the incidence and intensity of persistent postoperative pain after hernia repair. Objectives: To evaluate whether prophylactic ilioinguinal neurectomy prevents chronic groin pain after primary Lichtenstein hernia repair.Methods: Patients undergoing elective open mesh repair of inguinal hernia were randomized in two groups; nerve excision and nerve preservation group by opaque envelope method. Fifty cases were included in each group. A telephone interview was conducted after three months of the surgery. Pain scoring was done with Numeric Pain Intensity Scale and its effect in daily activities was measured with Patient Disability Index.Results: Forty-four patients in excision group and 45 in preservation group satisfied the inclusion criteria. Nine (20%) in the previous group and 16 (34.78%) in the latter group had chronic pain (p=0.113). Mean severity score in patients who had pain was significantly high in preservation group (2.22 versus 3.31, p=0.039). The incidence of scrotal numbness was higher in excision group (20% versus 13.3%, p=0.370).Conclusion: Though insignificant reduction in incidence of chronic groin pain was observed after division of ilioinguinal nerve, significant reduction in the intensity of the chronic pain especially during activities related to home and during self care has been shown.Journal of Kathmandu Medical College, Vol. 4, No. 2, Issue 12, Apr.-Jun., 2015, Page: 39-44

scholarly journals Meta‐analysis of postoperative pain using non‐sutured or sutured single‐layer open mesh repair for inguinal hernia

BJS Open ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 260-273 ◽  
Author(s):  
S. van Steensel ◽  
L. K. van Vugt ◽  
A. K. Al Omar ◽  
E. H. H. Mommers ◽  
S. O. Breukink ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Mesh Repair ◽  
Meta Analysis ◽  
Single Layer ◽  
Open Mesh Repair ◽  
Open Mesh

scholarly journals Prophylactic ilio-inguinal neurectomy following Lichtenstein tension free hernioplasty for inguinal hernia: a prospective study

2019 ◽  
Vol 6 (8) ◽  
pp. 2731
Author(s):  
Preetham Raj G. ◽  
Nagaraja A. L. ◽  
Surendran V. ◽  
Abhilash Sharma ◽  
Ibrahim Shariff ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Prospective Study ◽  
Groin Pain ◽  
Chronic Groin Pain ◽  
Ilioinguinal Nerve ◽  
Tension Free ◽  
Nerve Preservation ◽  
Group A ◽  
Group B ◽  
A Prospective Study

Background: The objective of the study was to evaluate effect of prophylactic ilio-inguinal neurectomy on incidence of chronic groin pain following the Lichtenstein tension free hernioplasty for inguinal hernia.Methods: This prospective study included male cases admitted with uncomplicated inguinal hernia. Patients were categorised into two groups: Group A: Ilioinguinal nerve preserved, Group B: Ilioinguinal nerve excision. Standard tension-free Lichtenstein mesh repair was adopted. Patients were followed up for assessment of chronic groin pain, hypoesthesia, and numbness at post-operative day (POD) 3, POD14, 1 month and 3 months. Visual analog scale (VAS) was used to assess severity of pain. Sensory assessment was done using standard Semmes-Weinstein monofilament test. Student t test was used and a 2-sided p<0.05 was considered significant.Results: A total of 60 patients with uncomplicated inguinal hernia underwent Lichenstein mesh Hernioplasty (mean age of patients in nerve preservation: 35.8±11.9 years and nerve excision group: 42.7±9.6 years). Postoperative pain significantly decreased in group B at POD 3 (65.5% vs. 89.7%, p=0.01) and 3 months (0% vs. 24.1%, p=0.003) when compared to group A. Prevalence of numbness reduced significantly in group A at 3 month (44.8% vs. 86.2%, p=0.001). Although post-operative hypo aesthesia was comparable between the groups at POD 3 (84.6% vs. 78.1%), it decreased significantly in group A at 3 months (27.6 % vs. 86.2%, p<0.001) when compared to group B.Conclusions: Prophylactic excision of ilio-inguinal nerve during Lichtenstein mesh hernia repair decreases the incidence of chronic groin pain after surgery, without additional morbidities.

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