Inguinodynia after two inguinal herniorrhaphy methods

Area of Science:

• Surgery
• Gastroenterology
• Pain Management

Background:

• Postoperative neuralgia is a common complication following inguinal hernia repair.
• Comparing different surgical techniques is crucial for optimizing patient outcomes and minimizing nerve-related complications.

Purpose of the Study:

• To compare the incidence and characteristics of postoperative neuralgia between laparoscopic transabdominal hernioplasty (TAPP) and Lichtenstein tension-free hernia repair.
• To identify specific nerves affected and the duration of symptoms in each surgical group.

Main Methods:

• A prospective trial involving 400 patients undergoing inguinal hernia repair.
• 200 patients received TAPP, and 200 patients underwent Lichtenstein repair.
• Data collected included pain location, neuralgia characteristics, and time to complete pain resolution.

Main Results:

• The overall rate of nerve irritation was 7.6%. TAPP group: 5.5% incidence; Lichtenstein (LICH) group: 9.5% incidence (P = .03).
• The genitofemoral nerve was frequently affected (4.3%). In TAPP, the lateral cutaneous nerve of the thigh (LFC) was most affected (3.3%).
• Symptoms were more persistent in the LICH group, whereas most TAPP cases were transitory (P = .08).

Conclusions:

• Laparoscopic transabdominal hernioplasty (TAPP) demonstrates a lower rate of postoperative inguinal neuralgia compared to Lichtenstein repair.
• TAPP is associated with more transitory symptoms, while Lichtenstein repair may lead to more persistent neuralgia.
• Surgical technique significantly influences the risk and nature of postoperative nerve irritation after inguinal hernia repair.