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Updated: Aug 8, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Inguinodynia after two inguinal herniorrhaphy methods
Jose Bueno1, Alfonso Serralta, Manuel Planells
1Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario "La Fe," Valencia. buenolledo@hotmail.com
Insights
Laparoscopic transabdominal hernioplasty (TAPP) resulted in a lower rate of postoperative inguinal neuralgia compared to Lichtenstein repair. TAPP also showed more transitory symptoms, while Lichtenstein repair led to more persistent discomfort.
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.
Abstract:
The aim of this study was to compare the rate and characteristics of postoperative neuralgia after 2 methods of inguinal hernia repairs. Between July 1997 and December 2000, 400 inguinal hernia repairs were performed and followed up in a prospective trial about postoperative nerve irritations: 200 patients with laparoscopic transabdominal hernioplasty (TAPP group), and 200 patients with tension-free hernia repair using Lichtenstein's technique (LICH group). We applied a clinic protocol of data about pain location, neuralgia characteristics, and period of time until the patient was completely pain free. The global rate of nerve irritation in the study was 7.6% (30 cases); in the TAPP group, it was 5.5% (n = 11) and in the LICH group, it was 9.5% (n = 19) (P = .03). The genitofemoral nerve was affected with particularly high frequency (4.3% in the global series); although in laparoscopic repair, the lateral cutaneous nerve of the thigh (LFC) was most damaged (3.3% in TAPP group). We observed more persistent symptoms in LICH group, while in TAPP group the most of cases was transitory (P = .08). There were no significant differences in pain characteristics according to clinical type of hernia. The TAPP method causes less rate of postoperative inguinal neuralgia than Lichtenstein repair, emphasizing more persistent discomfort in anterior approach than laparoscopic repair.
