Ten steps for proper peripheral nerve handling during inguinal hernia surgery

A. De la Fuente Hagopian, S. Farhat, S. Guadarrama-Sistos Vazquez, N. K. Reddy, J. Bombardelli, A. Echo

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Post-inguinal pain after a hernia surgery is prevalent and can be quite frustrating for the surgeon and patient alike. There are several sources for possible post-operative inguinal pain after a successful hernia repair; however, in the setting where a recurrent inguinal hernia is not present, it is likely related to the nerves in the inguinal canal or pelvis. Chronic inguinal groin pain after hernia repairs have been reported in a high percentage of patients following inguinal hernia surgery despite being one of the most common procedures performed annually in the USA and worldwide. Materials and methods: We present ten of the basic concepts utilized by peripheral nerve surgeons to limit nerve injury, which can easily be applied to open inguinal hernia surgery with or without mesh, starting with the firm understanding of the inguinal anatomy to addressing the nerves, meticulous placement of the mesh and the active revision of the surrounding structures and nerve position before closure. Conclusions: Understanding the proper handling of the inguinal nerves during hernia surgery can decrease the incidence of post-operative chronic pain by employing microsurgical concepts to day-to-day surgical procedures and prevent complications in an extensive set of patients.

Original languageEnglish (US)
Pages (from-to)1607-1610
Number of pages4
JournalHernia
Volume27
Issue number6
DOIs
StatePublished - Dec 2023

Keywords

  • Chronic pain
  • Inguinal pain
  • Peripheral nerves

ASJC Scopus subject areas

  • Surgery

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