Medico-legal case series of litigation involving chronic post-herniorrhaphy inguinal pain: insights from Italian civil verdicts

Roberto Cirocchi ^1,2, Luca Tomassini ^3,4, Salvatore Guarino ⁵

⁰Department of Digestive and Emergency Surgery, "S.Maria" Hospital, Terni, Italy.

Hernia : the Journal of Hernias and Abdominal Wall Surgery +

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October 8, 2025

View abstract on PubMed

Summary

Chronic postherniorrhaphy inguinal pain (CPIP) litigation is linked to genitofemoral nerve injury. Compensation was more likely when this nerve was involved or after neurectomy, highlighting surgical documentation importance.

Area Of Science

Medical Law
Surgical Outcomes
Pain Management

Background

Chronic postherniorrhaphy inguinal pain (CPIP) is a recognized complication after hernia repair.
CPIP can lead to malpractice litigation, impacting patient care and surgeon liability.

Purpose Of The Study

To analyze medicolegal outcomes of civil verdicts concerning CPIP following inguinal hernia repair in Italy.
To identify factors associated with compensation in CPIP-related malpractice cases.

Main Methods

Retrospective review of Italian Ministry of Justice malpractice verdicts (2015-2025) related to CPIP.
Analysis of 17 cases, collecting data on nerve injury, surgical techniques, consent, and outcomes.
Descriptive statistical analysis to summarize findings.

Main Results

Compensation was awarded in 23.5% of cases.
Nerve injury occurred in 76.5% of cases, with genitofemoral nerve injury in 46.2% of those.
Genitofemoral nerve injury was associated with a higher compensation rate (66.7%) compared to cases without nerve injury.

Conclusions

Genitofemoral nerve injury shows a potential association with compensation in CPIP litigation.
Neurectomy and omissions in informed consent regarding nerve injury risk were also relevant factors.
Emphasizes the medico-legal importance of precise nerve identification, documentation, and patient consent in hernia surgery.

Keywords:

CPIP Chronic pain Inguinal hernia Malpractice Medico-legal claims Nerve injury