Laparoscopic inguinal ligament tenotomy and mesh reinforcement of the anterior abdominal wall: a new approach for the management of chronic groin pain.
BACKGROUND
Chronic groin pain has an incidence of up to 6.2% and is common in people undertaking regular sports activity. A variety of surgical options exist for unresolving pain, which consist, for the most part, of a repair of the posterior abdominal wall, with or without mesh placement. We describe a new technique, which combines laparoscopic inguinal ligament tenotomy in conjunction with a mesh repair.


METHODS
A retrospective analysis of the notes of 48 patients was undertaken in conjunction with a mailed questionnaire. Success of surgery was judged on return to preinjury sporting activity, severity of pain scores, frequency of pain scores, and functional limitation scores.


RESULTS
There were no major complications associated with the procedure. Severity of pain, frequency of pain, and functional limitation scores were all significantly improved after surgery (P=0.0012, <0.0001, and <0.0001, respectively). Ninety-two percent of patients polled returned to normal sports activity after their surgery (n=24). The median return to strenuous sports activity was 28 days (range of 14 to 40 d).


CONCLUSIONS
The success rates of laparoscopic tenotomy and mesh repair are comparable with the published literature and a lower median time interval before returning to preinjury sporting activity.
Lloyd
David M
DM
Department of Laparoscopic and Upper Gastrointestinal Surgery, The Leicester Royal Infirmary, Leicester.
Sutton
Christopher D
CD
Altafa
Aminah
A
Fareed
Kaleel
K
Bloxham
Lisa
L
Spencer
Laura
L
Garcea
Giuseppe
G
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006119:Groin; D006801:Humans; D007264:Inguinal Canal; D010535:Laparoscopy; D008022:Ligaments / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013526:Surgical Mesh; D013710:Tendons / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult