Inguinal neurectomy for nerve entrapment after open/laparoscopic hernia repair using retroperitoneal endoscopic approach

Muto, Crescenzo; Pedana, N.; Scarpelli, Sophia; Galardo, R.; Guida, Gustavo; Schiavone, Vincenzo

doi:10.1007/s00464-004-2007-8

Cited by 25 publications

(18 citation statements)

References 19 publications

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“…Excellent pain relief and morbidity rates, comparable to those for open neurectomy, have been reported using this approach 15,16 . The authors' experience with 39 patients is reported here.…”

Section: Introductionmentioning

confidence: 80%

Endoscopic retroperitoneal neurectomy for chronic pain after groin surgery

Giger

Wente

Büchler

et al. 2009

British Journal of Surgery

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Section: Introductionmentioning

confidence: 80%

Endoscopic retroperitoneal neurectomy for chronic pain after groin surgery

Giger

Wente

Büchler

et al. 2009

British Journal of Surgery

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“…The genital branch of the genitofemoral nerve can, according to Giger, not be found through the anterior approach. Muto used the same approach and performed an ilioinguinal and genitofemoral neurectomy in 6 patients with 100% pain relief and postulated that these two nerves are responsible for the chronic groin pain after groin surgery [15]. …”

Section: Discussionmentioning

confidence: 99%

“…Surgery success rates in reducing chronic pain are variable, mainly depending on the patient selection criteria, and have been reported between 30% and 100% [9, 10]. Furthermore, minimal-invasive retroperitoneal approaches have also been described for accessing the groin nerves offering similar success rates [14, 15]. …”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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BackgroundChronic debilitating pain is a rare but significant cause of postoperative morbidity after inguinal surgery. Such pain is usually of neuropathic origin and frequently caused by intraoperative nerve damage. In this retrospective matched-pair study we analysed results of a minimal-invasive approach to neurectomy on quality of life and pain relief.MethodsFrom March 2010 to January 2012, 9 patients developing chronic neuropathic pain after inguinal hernia repair (8 patients) or open appendicectomy (one patient) were operated using a laparoscopic transabdominal approach in our department. Clinical examinations and specific questionnaires on pain and quality of life (PainDetect, SF-36) were completed 6 months to 3 years after neurectomy. Every patient was matched with one patient without chronic pain.ResultsSeven of nine patients had severe or very severe pain before neurectomy, two had mild pain but refused a conservative treatment. Four patients were free of pain after neurectomy, three described an improved pain status, whereas two did not observe any change in pain. Within a follow-up period of 14,3 months, no deterioration of pain or other complications were observed. Patients who underwent neurectomy had significantly lower quality of life compared to the control group. No postoperative complications were observed.ConclusionsLaparoscopic transabdominal neurectomy represents a possible surgical approach in treating patients with chronic disabling postoperative groin pain requiring surgery. This technique was feasible, safe, and effective in our series to relieve chronic debilitating pain in the majority of our patients with comparable results to other published approaches.

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“…8,74,134,135 The retroperitoneal endoscopic approach for a neurectomy appears promising for treating the inguinal entrapment neuralgia because it appears to be a fairly simple technique. 136 A triple neurectomy approach has been suggested because the ilioinguinal iliohypogastric and genital branch of the genitofemoral nerves all communicate, and the discrimination of which nerves are involved may be diffi cult. 134 With this approach, the entire length of the nerves should be resected and ligated to prevent the formation of neuroma.…”

Section: Surgerymentioning

confidence: 99%

Pain following the repair of an abdominal hernia

2009

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Pain and other types of discomfort are frequent symptoms following the repair of an abdominal hernia. After 1 year, the incidence of light to moderate pain following inguinal hernia repair is as high as 10% and 2% for severe disabling chronic pain. Postoperative chronic pain not only affects the individual patient, but may also have a great impact on relatives and society, and may be a cause of concern for the responsible surgeon. This paper provides an overview of the anatomy, surgical procedures, and disposing factors (age, gender, ethnicity, genotype, previous hernia repair, pain prior to surgery, psychosocial characteristics, and surgical procedures) related to the postoperative pain conditions. Furthermore, the mechanisms for both acute and chronic pain are presented. We focus on inguinal hernia repair, which is the most frequent type of abdominal hernia surgery that leads to chronic pain. Finally, the paper provides an update on the diagnostic and treatment routines for postoperative pain.

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Inguinal neurectomy for nerve entrapment after open/laparoscopic hernia repair using retroperitoneal endoscopic approach

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

Cited by 25 publications

References 19 publications

Endoscopic retroperitoneal neurectomy for chronic pain after groin surgery

Endoscopic retroperitoneal neurectomy for chronic pain after groin surgery

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

Pain following the repair of an abdominal hernia

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