Nerve irritation after laparoscopic hernia repair.
BACKGROUND
Between October 1992 and May 1996, 893 hernia repairs were performed at the Surgical Clinic in Mannheim: 448 (50%) using laparoscopy (TAPP-method) and 445 (50%) using the conventional anterior approach (Shouldice).


METHODS
For this study, 723 (81%) of these repairs were followed up in a prospective trial of postoperative nerve irritations.


RESULTS
The rate of nerve entrapment in the laparoscopic group was 4.2% (n = 19), and in the group that underwent conventional surgery 1.8% (n = 8). The genitofemoral nerve was affected with particularly high frequency (2%), and the ilioinguinal nerve and lateral cutaneous nerve of the thigh (LCNT) each was affected in 1.1% of the cases.


CONCLUSIONS
Reduction in the number of clips used and careful attention to the anatomic nerve course during preparation and placement of mesh led to a significant reduction in the occurrence of nerve irritations. In the last 100 patients who underwent laparoscopic hernia repair, only one nerve lesion was seen.
Stark
E
E
Surgical Clinic, Mannheim Clinic of Heidelberg University, Parkstrasse 15, D-74189 Weinsberg, Germany.
Oestreich
K
K
Wendl
K
K
Rumstadt
B
B
Hagmüller
E
E
D005260:Female; D006119:Groin / Q000294:innervation; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D009408:Nerve Compression Syndromes / Q000209:etiology; D059348:Peripheral Nerve Injuries; D011446:Prospective Studies; D013525:Surgical Instruments / Q000009:adverse effects; D013848:Thigh / Q000294:innervation