Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Hernia
Published in: Hernia 1/2010

01-02-2010 | Original Article

A method for the reduction of chronic pain after tension-free repair of inguinal hernia: iliohypogastric neurectomy and subcutaneous transposition of the spermatic cord

Authors: K. Caliskan, T. Z. Nursal, E. Caliskan, A. Parlakgumus, S. Yıldırım, T. Noyan

Published in: Hernia | Issue 1/2010

Login to get access

Abstract

Purpose

We assessed the efficacy of iliohypogastric neurectomy and subcutaneous transposition of the spermatic cord and ilioinguinal and genital nerves on the incidence of postoperative chronic pain (PCP) after open inguinal hernia repair with polypropylene mesh.

Methods

Between October 2006 and November 2006, 54 adult male patients with primary inguinal hernia were randomised into two groups. In group A, we performed Lichtenstein hernia repair, neurectomy and the new procedure; in group B, only Lichtenstein’s operation was performed.

Results

One month after operation, the incidence rate of PCP was significantly lower in group A. At 6 months, there was no significant difference between both groups regarding PCP at rest and coughing. However, there were no patients who complained of PCP after walking and climbing up stairs in group A. The sensorial changes in the groin region were similar in the two groups.

Conclusion

This procedure decreases the incidence of physical activity-induced PCP, without increasing the risks of sensory changes.
Literature
1.
Bringman S, Ramel S, Heikkinen TJ, Englund T, Westman B, Anderberg B (2003) Tension-free inguinal hernia repair: TEP versus mesh-plug versus Lichtenstein: a prospective randomized controlled trial. Ann Surg 237:142–147CrossRefPubMed
2.
Kumar S, Wilson RG, Nixon SJ, Macintyre IM (2002) Chronic pain after laparoscopic and open mesh repair of groin hernia. Br J Surg 89:1476–1479CrossRefPubMed
3.
MRC Laparoscopic Groin Hernia Trial Group (1999) Laparoscopic versus open repair of groin hernia: a randomised comparison. Lancet 354:185–190CrossRef
4.
Fränneby U, Sandblom G, Nordin P, Nyrén O, Gunnarsson U (2006) Risk factors for long-term pain after hernia surgery. Ann Surg 244:212–219CrossRefPubMed
5.
Poobalan AS, Bruce J, Smith WC, King PM, Krukowski ZH, Chambers WA (2003) A review of chronic pain after inguinal herniorrhaphy. Clin J Pain 19:48–54CrossRefPubMed
6.
Bay-Nielsen M, Perkins FM, Kehlet H; Danish Hernia Database (2001) Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg 233:1–7CrossRefPubMed
7.
Mui WL, Ng CS, Fung TM, Cheung FK, Wong CM, Ma TH, Bn MY, Ng EK (2006) Prophylactic ilioinguinal neurectomy in open inguinal hernia repair: a double-blind randomized controlled trial. Ann Surg 244:27–33CrossRefPubMed
8.
Malekpour F, Mirhashemi SH, Hajinasrolah E, Salehi N, Khoshkar A, Kolahi AA (2008) Ilioinguinal nerve excision in open mesh repair of inguinal hernia—results of a randomized clinical trial: simple solution for a difficult problem? Am J Surg 195:735–740CrossRefPubMed
9.
Picchio M, Marcello P, Palimento D, Matarazzo PF, Bambini C, Caliendo A (2004) Randomized controlled trial of preservation or elective division of ilioinguinal nerve on open inguinal hernia repair with polypropylene mesh. Arch Surg 139:755–758CrossRefPubMed
10.
Wijsmuller AR, van Veen RN, Bosch JL, Lange JF, Kleinrensink GJ, Jeekel J, Lange JF (2007) Nerve management during open hernia repair. Br J Surg 94:17–22CrossRefPubMed
11.
Zieren J, Tsigris Ch, Menenakos Ch (2007) Open tension-free hernia repair in soccer players: preservation or primary neurectomy of the ilioinguinal nerve? Clin J Sport Med 17:398–400CrossRefPubMed
12.
Amid PK, Shulman AG, Lichtenstein IL (1996) Open “tension-free” repair of inguinal hernias: the Lichtenstein technique. Eur J Surg 162:447–453PubMed
13.
Cunningham J, Temple WJ, Mitchell P, Nixon JA, Preshaw RM, Hagen NA (1996) Cooperative hernia study. Pain in the postrepair patient. Ann Surg 224:598–602CrossRefPubMed
14.
Amid PK (2004) Causes, prevention, and surgical treatment of postherniorrhaphy neuropathic inguinodynia: triple neurectomy with proximal end implantation. Hernia 8:343–349CrossRefPubMed
15.
Heise CP, Starling JR (1998) Mesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy? J Am Coll Surg 187:514–518CrossRefPubMed
16.
Loos MJ, Roumen RM, Scheltinga MR (2007) Classifying post-herniorrhaphy pain syndromes following elective inguinal hernia repair. World J Surg 31:1760–1765CrossRefPubMed
17.
Demirer S, Kepenekci I, Evirgen O, Birsen O, Tuzuner A, Karahuseyinoglu S, Ozban M, Kuterdem E (2006) The effect of polypropylene mesh on ilioinguinal nerve in open mesh repair of groin hernia. J Surg Res 131:175–181CrossRefPubMed
18.
EU Hernia Trialists Collaboration (2002) Repair of groin hernia with synthetic mesh: meta-analysis of randomized controlled trials. Ann Surg 235:322–332CrossRef
19.
Alfieri S, Rotondi F, Di Giorgio A, Fumagalli U, Salzano A, Di Miceli D, Ridolfini MP, Sgagari A, Doglietto G; Groin Pain Trial Group (2006). Influence of preservation versus division of ilioinguinal, iliohypogastric, and genital nerves during open mesh herniorrhaphy: prospective multicentric study of chronic pain. Ann Surg 243:553–558CrossRefPubMed
20.
O’Dwyer PJ, Kingsnorth AN, Molloy RG, Small PK, Lammers B, Horeyseck G (2005) Randomized clinical trial assessing impact of a lightweight or heavyweight mesh on chronic pain after inguinal hernia repair. Br J Surg 92:166–170CrossRefPubMed
21.
Post S, Weiss B, Willer M, Neufang T, Lorenz D (2004) Randomized clinical trial of lightweight composite mesh for Lichtenstein inguinal hernia repair. Br J Surg 91:44–48CrossRefPubMed
22.
Zieren J, Rosenberg T, Menenakos Ch (2008) Impact of ilio-inguinal nerve excision on sexual function in open inguinal hernia mesh repair: a prospective follow-up study. Acta Chir Belg 108:409–413PubMed
23.
Pappalardo G, Frattaroli FM, Mongardini M, Salvi PF, Lombardi A, Conte AM, Arezzo MF (2007) Neurectomy to prevent persistent pain after inguinal herniorraphy: a prospective study using objective criteria to assess pain. World J Surg 31:1081–1086CrossRefPubMed
Metadata
Title
A method for the reduction of chronic pain after tension-free repair of inguinal hernia: iliohypogastric neurectomy and subcutaneous transposition of the spermatic cord
Authors
K. Caliskan
T. Z. Nursal
E. Caliskan
A. Parlakgumus
S. Yıldırım
T. Noyan
Publication date
01-02-2010
Publisher
Springer-Verlag
Published in
Hernia / Issue 1/2010
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-009-0571-5

Other articles of this Issue 1/2010

Hernia 1/2010 Go to the issue

Original Article

Sportsmen hernia: what do we know?

Original Article

Management of complicated umbilical hernias in cirrhotic patients using permanent mesh: randomized clinical trial

Original Article

Ambulatory hernia surgery under local anesthesia is feasible and safe in obese patients

Obituary

Dr. John Skandalakis, 1920–2009

Case Report

Initial experience with transvaginal incisional hernia repair

Congress Report

Hernia repair: the search for ideal meshes