Triple neurectomy following Lichtenstein repair of inguinal hernia

Česká verzia

Authors: B. Jíšová; P. Hladík; B. East
Authors place of work: III. chirurgická klinika, 1. lékařská fakulta Karlovy univerzity a Fakultní nemocnice v Motole, Praha, Česká republika
Published in the journal: Rozhl. Chir., 2023, roč. 102, č. 9, s. 363-365.
Category: Case Reports
doi: https://doi.org/10.33699/PIS.2023.102.9.363–365

Summary

Introduction: Chronic pain is a distressing complication that can occur after inguinal hernia repair, affecting between 5% and 20% of patients as reported in literature. There are several reasons for chronic pain, including peripheral nerve irritation caused by surgical mesh or stitches. Preoperative pain is a risk factor for chronic pain.
Case report: We present the case of a 59-year-old man who experienced chronic inguinal pain following Lichtenstein hernia repair. Conservative therapy was ineffective, and he subsequently underwent triple neurectomy without removal of the original polypropylene mesh. The patient experienced significant pain relief immediately after the surgery. There was no reported pain 1 month and 1 year post-surgery.
Conclusion: The management of patients with chronic pain following hernia repair should be comprehensive and, ideally, centralized. Conservative procedures should be attempted first, but neurectomy and mesh removal may be necessary in cases where conservative measures are unsuccessful.

Keywords:

inguinal hernia – chronic pain – neurectomy – Lichtenstein hernia repair

Zdroje

1. Duda M, Czudek S a kol. Diagnostika a léčba kýl dutiny břišní. Speciální chiurugie 2012 E-portál. http://eportal.chirurgie.upol.cz/portal_final/?page_id=2459.

2. Nosková P. Chronická bolest, diagnostika, terapie. Interní Med. 2010;12(4):200–204. 7.

3. Andresen K, Rosenberg J. Management of chronic pain after hernia repair. J Pain Res. 2018;11:675−681. https://doi.org/10.2147/JPR.S127820.

4. Wise J. Hernia mesh complications may 8. have affected up to 170 000 patients, investigation finds. BMJ 2018. doi:10.1136/ bmj.k4104.

5. Bischoff JM, Aasvang EK, Kehlet H, et al. Does nerve identification during open 9. inguinal herniorrhaphy reduce the risk of nerve damage and persistent pain? Hernia 2012;16(5):573–577. doi:10.1007/ s10029-012-0946-x.

6. Amid PK. Radiologic images of meshoma: a new phenomenon causing chronic pain after prosthetic repair of abdominal wall hernias. Arch Surg. 2004 Dec;139(12):1297−1298. doi:10.1001/archsurg.139.12.1297. PMID: 15611452.

7. Nikkolo C, Lepner U. Chronic pain after open inguinal hernia repair. Postgrad Med. 2016 Jan;128(1):69−75. doi:10.108 0/00325481.2016.1121090. Epub 2015 Dec 4. PMID: 26567717.

8. Aasvang E, Kehlet H. Surgical management of chronic pain after inguinal hernia repair. British Journal of Surgery 2005;92(7):795–801. doi:10.1002/ bjs.5103.

9. Bullen NL, Massey LH, Antoniou SA, et al. Open versus laparoscopic mesh repair of primary unilateral uncomplicated inguinal hernia: a systematic review with meta-analysis and trial sequential analysis. Hernia 2019 Jun;23(3):461−472.doi:10.1007/s10029-019-01989-7. Epub 2019 Jun 3.

10. Lange JFM, Kaufmann R, Wijsmuller AR, et al. An international consensus algorithm for management of chronic postoperative inguinal pain. Hernia 2015;19:33–43. doi:10.1007/s10029-014-1292-y.

11. Amid PK, Chen DC. Surgical treatment of chronic groin and testicular pain after laparoscopic and open preperitoneal inguinal hernia repair. J Am Coll Surg. 2011;213(4):531–536.

12. HerniaSurge Group. International guidelines for groin hernia management. Hernia 2018 Feb;22(1):1−165. doi: 10.1007/ s10029-017-1668-x. Epub 2018 Jan 12.

13. Hu QL, Chen DC. Approach to the patient with chronic groin pain. Surg Clin North Am. 2018 Jun;98(3):651−665. doi: 10.1016/j.suc.2018.02.002. Epub 2018 Apr 4.

Štítky

Surgery Orthopaedics Trauma surgery

Článek Gastarbeiter’s look back (or a handful of observations for those interested in professional exile)

Článek Surgical therapy of chronic lung allograft dysfunction

Článek Treatment of the congenital thoracic deformity pectus excavatum

Článek Blood loss during HPB procedures

Článek Giant peritoneal loose body – case report

Článok vyšiel v časopise

Perspectives in Surgery

2023 Číslo 9

Najčítanejšie tento týždeň

Najčítanejšie v tomto čísle