Meralgia paresthetica: a complication of laparoscopic herniorrhaphy

Laparoscopic herniorrhaphy is a new and presently evolving technique applied to the repair of inguinal defects. Many different authors have described various methods by which this can be achieved. Some of these include the transabdominal preperitoneal approach, the plug technique, the intraperitoneal onlay of mesh, and the extraperitoneal approach. The authors have performed 252 laparoscopic hernia repairs utilizing a form of the transabdominal preperitoneal procedure that is referred to as the "transperitoneal anatomic approach." The development of new procedures or the modification of existing procedures can create new problems or alter the pattern of traditional complications. These problems must be thoroughly evaluated and reported if repetition of these errors is to be avoided. Five cases of meralgia paresthetica are reported that resulted from staple entrapment of the lateral femoral cutaneous nerve during laparoscopic herniorrhaphy. An understanding of the preperitoneal inguinal anatomy and precise placement of staples will allow avoidance of this complication.