A Case of Chronic Pain following Inguinal Hernia Surgery Treated with Neurectomy by Hybrid Surgery

Abstract

A 63-year-old man underwent anterior iliopubic tract repair of an incarcerated right inguinal hernia. From the day after surgery, the patient complained of pain in the region supplied by the genital branch of the genitofemoral nerve, and a policy of watchful waiting with analgesic use was adopted. However, the symptoms not only failed to improve, but became sufficiently severe to interfere with walking, and triple neurectomy by hybrid surgery was therefore performed 1 year 4 months after the initial surgery. The iliohypogastric and ilioinguinal nerves were first identified and resected via an inguinal incision. The genitofemoral nerve was then identified and resected laparoscopically. The inguinal floor was also reinforced with mesh. The pain improved postoperatively, and the patient was discharged on postoperative Day 2. Today, 1 year 11 months after the second surgery, there has been no flare-up of pain or hernia recurrence, and outpatient follow-up is ongoing.