Laparoscopic treated neuralgia after inguinal hernia repair: case report and literature review

Abstract

Background: Neuralgia after inguinal hernia repair is a known but potential invalidating complication with a reported incidence of 10-12%. Diagnosis and treatment can be challenging. Based on a case report and literature review, disease aspects and treatment options including laparoscopic (triple) neurectomy are discussed. Methods: A case of laparoscopic treated neuralgia after hernia inguinalis repair is reported. After an extensive MeSH-term based literature search, 26 articles were included for in-depth analysis and literature review. Results: Pharmacotherapy encounters high numbers needed to treat and technical procedures often require re-intervention. Surgery should only be considered after one year of unsuccessful conventional treatment. Laparoscopic (triple) neurectomy is a minimal invasive procedure, providing optimal visualisation of the inguinal nerves. It is reported to be a safe and effective treatment option for refractory inguinal neuralgia. Conclusions: Chronic neuralgia can be a severe complication after inguinal hernia repair. When pharmacotherapy and technical interventions are not sufficient, a laparoscopic (triple) neurectomy can be a promising, safe and effective treatment option.