Nerve injury associated with laparoscopic inguinal herniorrhaphy.

Abstract

As laparoscopic herniorrhaphy becomes more popular, it is important to realize the potential for injury to surrounding neural structures, with attendant severe disability. Herein are discussed two patients with disabling neuralgia after laparoscopic herniorrhaphy. Both patients were treated with transabdominal removal of their prosthetic materials and anchoring staples, with dramatic symptomatic improvement. The surgeon should be aware of the anatomic considerations accompanying laparoscopic herniorrhaphy. In regard to nerve injury, laparoscopic herniorrhaphy may pose certain disadvantages over traditional hernia repairs. It may diminish the ability to appreciate the course of nerves in the inguinal region and their relationship to the spermatic cord, and injury to nerves may be difficult to recognize and treat.