Entrapment neuropathy in laparoscopic herniorrhaphy.
In laparoscopic hernia repairs, the staples used to affix prosthetic mesh have resulted in entrapment neuropathies. This paper describes the diagnosis and treatment of nine cases of entrapment neuropathy. Injuries to all the branches of the lumbar plexus, with the exception of the obdurator nerve, have been treated. Generally, the entrapments are self-limiting, but chronic disability requiring surgical intervention can occur. Staple removal and neurolysis controlled the severe, chronic pain of one femoral nerve entrapment. A thorough understanding of the anatomy of these nerves can prevent stapling in the areas of danger and thus greatly reduce the incidence of this complication.
Seid
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Saint John's Hospital and Health Center, Santa Monica, CA 90404.
Amos
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D005267:Femoral Nerve / Q000293:injuries; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008160:Lumbosacral Plexus / Q000033:anatomy & histology / Q000293:injuries*; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D013526:Surgical Mesh; D017792:Surgical Stapling / Q000009:adverse effects / Q000295:instrumentation