Inguinal Neurectomy for Nerve Entrapment After Open/laparoscopic Hernia Repair Using Retroperitoneal Endoscopic Approach

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2005 May 28

PMID 15920696

Citations 6

Authors

C M Muto

N Pedana

S Scarpelli

R Galardo

G Guida

V Schiavone

Affiliations

Soon will be listed here.

Abstract

Background: Inguinal neuralgia after open and laparoscopic hernia, repair occurs in about 0.5% of treated patients. If the pain and the functional inability persist, it is possible that the genitofemoral nerve and ileoinguinal nerve are involved in entrapment, and surgical treatment is a possible option. This paper reports a personal endoscopic retroperitoneal approach for ileoinguinal and genitofemoral branches neurectomy.

Methods: A 12-mm trocar is inserted into the lower retroperitoneum and insufflated to create a work space. Neurectomy is performed under endoscopic guidance.

Results: Six patients were treated using this technique. The operating time was 55 min, and all patients were completely pain-free after surgery. All patients were discharged the first day after operation and there were no complications.

Conclusion: This retroperitoneal endoscopic approach is proposed as a new surgical technique for treating inguinal entrapment neuralgia. It is simple and feasible.

Citing Articles

Is pain control for chronic neuropathic pain after inguinal hernia repair using endoscopic retroperitoneal neurectomy effective? A meta-analysis of 142 patients from 1995 to 2022.

Taha-Mehlitz S, Taha A, Janzen A, Saad B, Hendie D, Ochs V Langenbecks Arch Surg. 2023; 408(1):39.

PMID: 36652009 PMC: 9849289. DOI: 10.1007/s00423-022-02748-6.

Transabdominal laparoscopic retroperitoneal neurectomy for chronic pain after inguinal hernia repair and appendicectomy -a matched-pair study.

Karampinis I, Weiss J, Pilz L, Post S, Herrle F BMC Surg. 2017; 17(1):85.

PMID: 28728601 PMC: 5520326. DOI: 10.1186/s12893-017-0282-2.

Surgical management of postoperative chronic inguinodynia by laparoscopic transabdominal preperitoneal approach.

Moreno-Egea A Surg Endosc. 2016; 30(12):5222-5227.

PMID: 27005291 DOI: 10.1007/s00464-016-4867-0.

Reoperation for persistent pain after groin hernia surgery: a population-based study.

Magnusson N, Gunnarsson U, Nordin P, Smedberg S, Hedberg M, Sandblom G Hernia. 2014; 19(1):45-51.

PMID: 25519077 DOI: 10.1007/s10029-014-1340-7.

Invited commentary: Persistent pain after inguinal hernia repair: what do we know and what do we need to know?.

Kehlet H, Roumen R, Reinpold W, Miserez M Hernia. 2013; 17(3):293-7.

PMID: 23686405 DOI: 10.1007/s10029-013-1109-4.

References

Wurtz A . [Endoscopy of the retroperitoneal space. Technics, results and current indications]. Ann Chir. 1989; 43(6):475-80. View

Knockaert D, DHeygere F, Bobbaers H . Ilioinguinal nerve entrapment: a little-known cause of iliac fossa pain. Postgrad Med J. 1989; 65(767):632-5. PMC: 2429177. DOI: 10.1136/pgmj.65.767.632. View

Luijendijk R, Jeekel J, Storm R, Schutte P, Hop W, DROGENDIJK A . The low transverse Pfannenstiel incision and the prevalence of incisional hernia and nerve entrapment. Ann Surg. 1997; 225(4):365-9. PMC: 1190743. DOI: 10.1097/00000658-199704000-00004. View

Sippo W, Gomez A . Nerve-entrapment syndromes from lower abdominal surgery. J Fam Pract. 1987; 25(6):585-7. View

Moro T, Kikuchi S, Konno S, Yaginuma H . An anatomic study of the lumbar plexus with respect to retroperitoneal endoscopic surgery. Spine (Phila Pa 1976). 2003; 28(5):423-8; discussion 427-8. DOI: 10.1097/01.BRS.0000049226.87064.3B. View

Bartel M . [Retroperitoneoscopy. An endoscopic method for inspection and bioptic examination of the retroperitoneal space]. Zentralbl Chir. 1969; 94(12):377-83. View

Benini A . [Ilio-inguinal and genito-femoral neuralgia. Causes, clinical aspects, therapy]. Schweiz Rundsch Med Prax. 1992; 81(38):1114-20. View

MOOSMAN D, Oelrich T . Prevention of accidental trauma to the iloinguinal nerve during inguinal hernoirrhaphy. Am J Surg. 1977; 133(2):146-8. DOI: 10.1016/0002-9610(77)90068-x. View

PURVES J, Miller J . Inguinal neuralgia: a review of 50 patients. Can J Surg. 1986; 29(1):43-5. View

10.

Stulz P, PFEIFFER K . Peripheral nerve injuries resulting from common surgical procedures in the lower portion of the abdomen. Arch Surg. 1982; 117(3):324-7. DOI: 10.1001/archsurg.1982.01380270042009. View

11.

Harms B, DeHaas Jr D, Starling J . Diagnosis and management of genitofemoral neuralgia. Arch Surg. 1984; 119(3):339-41. DOI: 10.1001/archsurg.1984.01390150071017. View

12.

O Broin E, Horner C, Mealy K, Kerin M, Gillen P, OBrien M . Meralgia paraesthetica following laparoscopic inguinal hernia repair. An anatomical analysis. Surg Endosc. 1995; 9(1):76-8. DOI: 10.1007/BF00187893. View

13.

Kennedy E, Harms B, Starling J . Absence of maladaptive neuronal plasticity after genitofemoral-ilioinguinal neurectomy. Surgery. 1994; 116(4):665-70; discussion 670-1. View

14.

Starling J, Harms B, Schroeder M, EICHMAN P . Diagnosis and treatment of genitofemoral and ilioinguinal entrapment neuralgia. Surgery. 1987; 102(4):581-6. View

15.

Stark E, Oestreich K, Wendl K, Rumstadt B, Hagmuller E . Nerve irritation after laparoscopic hernia repair. Surg Endosc. 1999; 13(9):878-81. DOI: 10.1007/s004649901124. View

16.

Seid A, Amos E . Entrapment neuropathy in laparoscopic herniorrhaphy. Surg Endosc. 1994; 8(9):1050-3. DOI: 10.1007/BF00705717. View

17.

Eden C . Operative retroperitoneoscopy. Br J Urol. 1995; 76(1):125-30. DOI: 10.1111/j.1464-410x.1995.tb07845.x. View

18.

Lee C, Dellon A . Surgical management of groin pain of neural origin. J Am Coll Surg. 2000; 191(2):137-42. DOI: 10.1016/s1072-7515(00)00319-7. View

19.

HAHN L . Clinical findings and results of operative treatment in ilioinguinal nerve entrapment syndrome. Br J Obstet Gynaecol. 1989; 96(9):1080-3. DOI: 10.1111/j.1471-0528.1989.tb03385.x. View

20.

Heise C, Starling J . Mesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy?. J Am Coll Surg. 1998; 187(5):514-8. DOI: 10.1016/s1072-7515(98)00215-4. View