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Combined open and laparoscopic approach to chronic pain after inguinal hernia repair.
Am Surg. 2008 Aug; 74(8):695-700; discussion 700-1.AS

Abstract

Chronic groin pain is the most frequent long-term complication after inguinal hernia repair affecting up to 34 per cent of patients. Traditional surgical management includes groin exploration, mesh removal, and neurectomy. We evaluate outcomes of a combined laparoscopic and open approach to chronic pain after inguinal herniorrhaphy. All patients undergoing surgical exploration for chronic pain after inguinal herniorrhaphy were analyzed. In most, the operation consisted of mesh removal (open or laparoscopic), neurectomy, and placement of mesh in the opposite location of the first mesh (laparoscopic if the first was open and vice-versa). Main outcome measures included pain status, numbness, and hernia recurrence. Twenty-one patients (16 male and 5 female) with a mean age of 41 years (22-51 years) underwent surgical treatment for unilateral (n = 18) or bilateral (n = 3) groin pain. Percutaneous nerve block was unsuccessful in all patients. Four had previous surgery for pain. There were no complications. With a minimum of 6 weeks follow-up, 20 of 21 patients reported significant improvement or resolution of symptoms. A combined laparoscopic and open approach for postherniorrhaphy groin pain results in excellent patient satisfaction with minimal morbidity. It may be the preferred technique for the definitive management of chronic neuralgia after hernia repair.

Authors+Show Affiliations

Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, North Carolina 28203, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18705569

Citation

Keller, Jennifer E., et al. "Combined Open and Laparoscopic Approach to Chronic Pain After Inguinal Hernia Repair." The American Surgeon, vol. 74, no. 8, 2008, pp. 695-700; discussion 700-1.
Keller JE, Stefanidis D, Dolce CJ, et al. Combined open and laparoscopic approach to chronic pain after inguinal hernia repair. Am Surg. 2008;74(8):695-700; discussion 700-1.
Keller, J. E., Stefanidis, D., Dolce, C. J., Iannitti, D. A., Kercher, K. W., & Heniford, B. T. (2008). Combined open and laparoscopic approach to chronic pain after inguinal hernia repair. The American Surgeon, 74(8), 695-700; discussion 700-1.
Keller JE, et al. Combined Open and Laparoscopic Approach to Chronic Pain After Inguinal Hernia Repair. Am Surg. 2008;74(8):695-700; discussion 700-1. PubMed PMID: 18705569.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined open and laparoscopic approach to chronic pain after inguinal hernia repair. AU - Keller,Jennifer E, AU - Stefanidis,Demitrios, AU - Dolce,Charles J, AU - Iannitti,David A, AU - Kercher,Kent W, AU - Heniford,B Todd, PY - 2008/8/19/pubmed PY - 2008/9/17/medline PY - 2008/8/19/entrez SP - 695-700; discussion 700-1 JF - The American surgeon JO - Am Surg VL - 74 IS - 8 N2 - Chronic groin pain is the most frequent long-term complication after inguinal hernia repair affecting up to 34 per cent of patients. Traditional surgical management includes groin exploration, mesh removal, and neurectomy. We evaluate outcomes of a combined laparoscopic and open approach to chronic pain after inguinal herniorrhaphy. All patients undergoing surgical exploration for chronic pain after inguinal herniorrhaphy were analyzed. In most, the operation consisted of mesh removal (open or laparoscopic), neurectomy, and placement of mesh in the opposite location of the first mesh (laparoscopic if the first was open and vice-versa). Main outcome measures included pain status, numbness, and hernia recurrence. Twenty-one patients (16 male and 5 female) with a mean age of 41 years (22-51 years) underwent surgical treatment for unilateral (n = 18) or bilateral (n = 3) groin pain. Percutaneous nerve block was unsuccessful in all patients. Four had previous surgery for pain. There were no complications. With a minimum of 6 weeks follow-up, 20 of 21 patients reported significant improvement or resolution of symptoms. A combined laparoscopic and open approach for postherniorrhaphy groin pain results in excellent patient satisfaction with minimal morbidity. It may be the preferred technique for the definitive management of chronic neuralgia after hernia repair. SN - 0003-1348 UR - https://www.unboundmedicine.com/medline/citation/18705569/Combined_open_and_laparoscopic_approach_to_chronic_pain_after_inguinal_hernia_repair_ L2 - https://www.ingentaconnect.com/openurl?genre=article&issn=0003-1348&volume=74&issue=8&spage=695&aulast=Keller DB - PRIME DP - Unbound Medicine ER -