Can open
inguinal hernia repair (OIHR) and tailored
neurectomy (TN) be effective for prophylaxis of chronic postoperative
inguinal hernia repair (
CPIP) (I) and treatment of
CPIP (II)? Patients with symptomatic primary
inguinal hernia (I group 1) and secondary
hernia with
CPIP (II, groups 2-5) were investigated for postoperative complications and nerve damage. About, 98% of patients with OIHR with TN reported preoperative
pain (I group 1, n = 388, recurrence rate 1%). There were 73 cases (II) of
CPIP after laparoscopic
inguinal hernia repair (LIHR) (group 2, n = 22), OIHR (group 3, n = 37), LIHR followed by OIHR/LIHR (group 4, n = 5) and OIHR followed by LIHR/OIHR (group 5, n = 9). The results were as follows: preoperative
pain: 33-100%, recurrence rate 0-11% (II, groups 2-5), nerve damage 92-100% and persistent
CPIP: n = 1 after
trocar perforation of inguinal nerve elsewhere. OIHR is effective to avoid
CPIP with
compression neuropathy. This is the largest series of histological nerve damage in
CPIP.