Inguinal hernia repair: can one identify the three main nerves of the region?

Abstract

OBJECTIVE:

To identify the nerves in the groin during inguinal hernia repair by inguinotomy.

METHODS:

We conducted a prospective, sequenced, non-randomized study comprising 38 patients undergoing inguinal hernia repair with placement of polypropylene mesh.

RESULTS:

The male patients were 36 (94.7%), with a mean age and standard deviation of 43.1 ± 14.5, body mass index of 24.4 ± 2.8. Comorbidities were hypertension in two (5.2%), smoking in 12 (31.5%) and obesity in two (5.2%). The hernia was located only on the right in 21 (55.2%) patients, only on the left in 11 (28.9%), and was bilateral in six (15.7%) patients. Prior hernia repair was present in seven (18.4%) patients. The identification of the three nerves during operation was made in 20 (52.6%) patients, the ilioinguinal nerve and the iliohypogastric nerve were identified in 33 (86.8%), and the genital nerve branch of the genitofemoral nerve, in 20 (52.6%). Resection of at least one of the nerves was performed in seven (18.4%) cases, two iliohypogastric nerves and five ilioinguinal nerves. The average operating time was 70.8 ± 18.2 minutes. The hospital stay was 1.42 ± 1.18 days. Ten patients (26.3%) returned to physical activity around the first postoperative visit, and 37 (97.3%) in the last. The follow-up time was 95.6 ± 23.5 days. The inability to identify the ilioinguinal nerve was associated with previous repair (p = 0.035).

CONCLUSION:

The identification of the three nerves during inguinal hernia surgery has been described in more than half of the cases and prior repair interfered with the identification of ilioinguinal nerve.

• Authors: João Vicente Machado Grossi, Leandro Totti Cavazzola, Ricardo Breigeiron
• Journal: Revista do Colegio Brasileiro de Cirurgioes (Rev Col Bras Cir) Vol. 42 Issue 3 Pg. 149-53 (Jun 2015) ISSN: 1809-4546 [Electronic] Brazil
• PMID: 26291254 (Publication Type: Journal Article)

Topics

• Adult
• Female
• Groin (innervation)
• Hernia, Inguinal (surgery)
• Herniorrhaphy (methods)
• Humans
• Male
• Non-Randomized Controlled Trials as Topic
• Prospective Studies