A Study for Short Term Neurosensory Effects of Prophylactic Ilioinguinal Neurectomy during Lichtenstein Repair of Inguinal Hernia

Chronic inguinodynia is one of the major problem arising after mesh hernioplasty leading to patient discomfort.The mechanism seems to be injury by suture, adherence to overlying implanted mesh, or involvement by scar tissue. Ilio-inguinal neurectomy during Lichtenstein hernioplasty may offers prophylaxis to such devastating pain. Our study aims to study the short term neurosensory effects of prophylactic ilioinguinal neurectomy during Lichtenstein repair of inguinal hernia. Methods and Material: This prospective observational study was conducted in thirty male patients aged 18-80 years who presented with inguinal hernia for elective Lichtenstein hernia repair. Postoperatively patients were assessed for pain, temperature, tactile sensation and numbness on day1, 7 and 30 after surgery. Severity of pain was assessed by Visual Analogue Scale. Results: Postoperatively mild pain was observed in 19(63.33%) patients and moderate pain was observed in11(36.63%) on day 1 post neurectomy. At 1 month post surgery 3(9.99%) patient complained of mild pain in groin region. There was no loss of temperature and pain sensation in any patient. Three (9.99%) patients experienced loss of touch sensation in the area of supply of ilioinguinal nerve on Semmes-Weinstein Monofilament (SWM) test, at post operative day 1 and 7. Out of which 2 patients regained their sensation to touch while one patient had persistent loss of sensation. Conclusion: prophylactic neurectomy of the inguinal nerves at the time of herniorrhaphy may decrease the incidence of post incisional neuropathy. -------------------------------------------------------------------------------------------------------------------------------------Date of Submission: 04-01-2019 Date of acceptance: 19-01-2019 -------------------------------------------------------------------------------------------------------------------------------------