Elective ilio-inguinal neurectomy for prevention of chronic pain after inguinal hernia meshplasty

Abstract

Background: This study has been carried out on 60 patients of inguinal hernia (either direct or indirect) from February 2016 to August 2017 who were admitted in the surgical ward of Index Medical College Hospital & Research Centre, Indore (M.P.). All patients were admitted through outpatient department. Method: The patients were divided into two groups: Group I and Group II. Each group consisted of 30 patients. Only male patients were included in the study. Surgery was organized within the hospital structure in the same way as other elective patients admitted in general surgical ward. Patient was fully explained about the procedure and its complications and was included in the study only after his written consent. Written explicit consent was taken in patients own language for group I patients. Result: The mean age of patients in nerve excision group (I) was 51.6 ± 18.1 years whereas in nerve preservation group (II) it was 50.3 ± 11.6 years. All the patients in both the groups were male. Patients suffering from pain were relatively much higher at 1 month irrespective of preservation or division of nerve. At 3 months after surgery both the groups had equal number of patients (2) with pain and continued resolution of pain symptom was thus noted. Conclusion:There is considerable evidence in world literature that supports the contention that in inguinal Hernia Meshplasty Neurectomy is associated with decreased incidence of pain after open hernia surgery. Keeping in mind the results emerging from the present study it may be suggested that routine identification and elective excision of the ilioinguinal nerve may be reasonable option without any significant added morbidity to prevent the chronic; pain in inguinal hernia repair with mesh. But a larger prospective randomized study is still required to confirm the benefit benefits of routine ilioinguinal neurectomy while doing open inguinal hernia repair with mesh.