Nerve irritation after laparoscopic hernia repair

Stark, Eberhard; Oestreich, Kerstin; Wendl, K.; Rumstadt, B.; Hagmüller, E.

doi:10.1007/s004649901124

Cited by 113 publications

(74 citation statements)

References 20 publications

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“…A meta-analysis conducted by Kaul et al [10] of 662 hernia repairs where in 394 mesh were fixed with tacks while in 268 mesh were fixed with fibrin glue found that incidence of pain was significantly higher in the tacker group. Stark et al [23] reported incidence of pain in 4.2 % of patients. Tolver et al [15] reported that day 1 scores and all cumulated scores of pain during rest, discomfort, and fatigue were significantly lower in the fibrin group compared with the tacker group (all p values ≤0.02)…”

Section: Groin Pain and Orchitismentioning

confidence: 97%

Comparison of the Clinical Outcome and Complications in Laparoscopic Hernia Repair of Inguinal Hernia With Mesh Fixation Using Fibrin Glue vs Tacker

Chandra¹,

Phalgune²,

Shah³

2015

Indian J Surg

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Although laparoscopic repair offers a quick and less morbid way of treating hernias, complications like hematoma, seroma, neuralgia, recurrence, mesh infection, hydrocele, etc. are known. The present study was undertaken to compare various clinical outcomes between mesh fixation using fibrin glue and mesh fixation with tacker in a 3-months follow-up. One hundred patients aged 18 to 60 years having inguinal hernia admitted in Poona Hospital and Research Centre, Pune, between October 2012 and November 2014 for laparoscopic hernia surgery and ready to participate in this study were included. All of them underwent laparoscopic repair of hernia by total extra peritoneal (TEP) method following sample surgical protocol in all of them except for method of mesh fixation. Mean time calculated from insertion of the first trocar to beginning of skin suturing was 54.9 min in tacker group and 50.3 min in fibrin glue group with no statistically significant difference between the two. The incidence of urinary retention was significantly higher in tacker (34 %) as compared to fibrin glue (12 %) group. Incidence of hematoma was significantly higher in tacker group in 15-day follow-up, but there was no significant difference in hematoma formation at hernial sites in both groups after 15 days of follow-up. The incidence of neuralgia was significantly higher in the tacker group (24 %) compared with the fibrin glue group (2 %). Significantly, more number of people in the fibrin glue group 68 and 90 %, respectively, returned to work during 15 and 30 days follow-up as compared to the tacker group 46 and 64 %. Fibrin glue can be considered as an alternative to tacker for mesh fixation.

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Section: Groin Pain and Orchitismentioning

confidence: 97%

Comparison of the Clinical Outcome and Complications in Laparoscopic Hernia Repair of Inguinal Hernia With Mesh Fixation Using Fibrin Glue vs Tacker

Chandra¹,

Phalgune²,

Shah³

2015

Indian J Surg

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“…Additionally, placement of staples in close proximity to the inguinal ligament (IL) during abdominal hernia repair (Eubanks, 2003) has resulted in compression of the LFCN and subsequent symptomatology associated with MP. Specifically, since the advent of laparoscopic hernia repair it has been reported that the incidence of iatrogenic MP has increased fivefold from 1 to 5% over open surgical procedures (Stark, 1999).…”

Section: Introductionmentioning

confidence: 99%

Variability of the lateral femoral cutaneous nerve: An anatomic basis for planning safe surgical approaches

et al. 2010

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Current surgical assumptions identify the lateral femoral cutaneous nerve (LFCN) running just under the inguinal ligament two fingerbreadths medial to the anterior superior iliac spine (ASIS). On the basis of the increasing incidence of Meralgia Paresthetica associated with various surgical procedures, it is clear that surgeons are relying on an inadequate description of the nerve's course. This study provides a better understanding of the variability of the LFCN with regards to its relationship to the ASIS and the depth at which it passes deep to the inguinal ligament. A total of 35 bodies were examined yielding 65 sets of data. Dissections were performed on 26 formalin fixed cadavers and 9 fresh morgue specimens. Measurements and calculations were made with regard to the distance from the LFCN to the ASIS along the inguinal ligament, the depth of the LFCN as it crossed the inguinal ligament, and the length of the inguinal ligament. The LFCN was observed to cross the inguinal ligament 1.4 +/- 0.4 cm medial to the ASIS with a standard deviation of 1.5 cm. The LFCN traversed the inguinal ligament 1.0 +/- 0.1 cm deep to the ligament with a standard deviation of 0.6 cm. The LFCN runs approximately one fingerbreadth medial to the ASIS. The nerve may be found far more medial or lateral than expected with several distinct branching patterns. In addition, the LFCN crosses deeper to the inguinal ligament than previously described in the literature, with a high variability of depth between specimens.

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“…The nerve then pierces the Obliquus internus (distributing filaments to it) just medial to the anterior superior iliac spine, at this point it becomes visible between the external and internal obliques and then it passes into the inguinal canal, accompanying the spermatic cord, through the subcutaneous inguinal ring. [3][4][5] After leaving the superficial inguinal ring, the ilioinguinal nerve subdivides into:…”

Section: Discussionmentioning

confidence: 99%

Ilio inguinal neurectomy in inguinal hernia

et al. 2017

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Background: Inguinal hernia is one of the most common surgery done in any hospital. Chronic inguinal pain is one of the common problem these patients complain of. This study aims at evaluating the long-term outcomes of neuralgia and paraesthesia following routine ilioinguinal nerve division, compared to nerve preservation when performing Lichtenstein’s inguinal hernia repair.Methods: The present study is a randomized controlled trial of 60 cases of inguinal hernias admitted in General Surgery Department in our hospital. The patients were randomly chosen into Lichtenstein hernia repair with ilioinguinal neurectomy or Lichtenstein hernia repair with nerve preservation. After surgery, all patients were monitored carefully for pain and paraesthesia. Pain was assessed using visual analogue scale. Paraesthesia was assessed by the monofilament test and evaluated after comparison with the opposite side.Results: In the present study, the incidence of pain as well as the severity of pain is far higher in the nerve preservation study group as opposed to the neurectomy study group. Hypaesthesia is not a significant complication following ilioinguinal neurectomy and does not significantly add to the morbidity of the patient.Conclusions: Prophylactic neurectomy can be an appropriate solution in the prevention of chronic groin pain following Lichtenstein inguinal hernia repair and can be considered as an ideal inclusion into the standard hernia repair procedures. Hypoesthesia is not a significant complication following ilioinguinal neurectomy and does not significantly add to the morbidity of the patient.

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Nerve irritation after laparoscopic hernia repair

Cited by 113 publications

References 20 publications

Comparison of the Clinical Outcome and Complications in Laparoscopic Hernia Repair of Inguinal Hernia With Mesh Fixation Using Fibrin Glue vs Tacker

Comparison of the Clinical Outcome and Complications in Laparoscopic Hernia Repair of Inguinal Hernia With Mesh Fixation Using Fibrin Glue vs Tacker

Variability of the lateral femoral cutaneous nerve: An anatomic basis for planning safe surgical approaches

Ilio inguinal neurectomy in inguinal hernia

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