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- Title
Variability in Ilioinguinal nerve anatomy during open hernia repair and its association with post-operative pain.
- Authors
Fateh, Omer; Irfan Wasi, Muhammad Samir; Rafiq, Syed Umar
- Abstract
Background: Inguinal hernia repair is one of the most commonly performed procedure worldwide and one of the most common complication of this procedure is post-operative pain which may be due to ilioinguinal nerve damage. The aim of this study is to establish the variability of ilioinguinal nerve and to establish the fact that there is no need to unnecessarily explore the operative region for nerve identification as it is spared due to its anatomical position. Material and Methods: It is a prospective, observational study conducted in Sindh Government Qatar Hospital from July 2016 to December 2016. The patients undergoing hernioplasty during this period were included in the study. There was no purposeful exploration done for the identification of ilioinguinal nerve. The patients were assigned four groups according to the status of identification and position of the ilioinguinal nerve. The first group included patients in which ilioinguinal nerve was not seen, the second group with those in whom ilioinguinal nerve was placed lateral to spermatic cord, the third group with nerve lying adherent to the cord and fourth one with nerve adherent to conjoint tendon. VAS (Visual Analogue Score) was recorded at discharge and at 6 months. The data was then analyzed via IBM SPSS Statistics version 23 Results: Out of the 57 patients included in the study, ilioinguinal nerve was identified intraoperatively in 37 (64.9%) patients while in 20 (35.1%) patients, ilioinguinal nerve was not seen intra-operatively. Among those patients in which the nerve was seen, 23(40.35%) patients had ilioinguinal nerve lying lateral to the spermatic cord while in 12(21.05%) patients the nerve was found adherent to the spermatic cord. In 2(3.51%) patients ilioinguinal nerve was found adherent to the conjoint tendon. VAS score assessment revealed no association of post-operative pain with ilioinguinal nerve identification or position. Conclusion: It is concluded from the study that the anatomical position of the ilioinguinal nerve is most likely to be found lateral to the spermatic cord or lying adherent to the spermatic cord; so there is minimal chance of nerve entrapment which alleviates the need for exploration of ilioinguinal nerve during hernioplasty.
- Subjects
INGUINAL hernia; HERNIA; SPERMATIC cord; SPERMATIC cord diseases; ABDOMINAL diseases
- Publication
Pakistan Journal of Surgery, 2018, Vol 34, Issue 1, p46
- ISSN
0258-8552
- Publication type
Article