Exploring the impact of prophylactic ilioinguinal neurectomy on neurosensory outcomes in Lichtenstein repair for inguinal hernia: A prospective investigation

Prolonged inguinodynia is a significant issue that arises following mesh hernioplasty. It appears that scar tissue, adhesion to the implanted mesh covering, or damage from sutures are the mechanisms at work. During a Lichtenstein hernioplasty, ileo-inguinal neurectomy may provide prophylaxis against such excruciating pain. The aim of current study is to assess how the implementation of prophylactic ilioinguinal neurectomy influences both the occurrence and intensity of chronic groin pain following a Lichtenstein tension-free repair. Material & methods: The prospective study was undertaken on 50 patients (two groups of 25 each) with inguinal hernia, admitted to the Department of Surgery, Punjab Institute of Medical Sciences, Jalandhar, Punjab. All routine investigations were done. Statistical analysis was done using SPSS software package 25.0 keeping level of significance at p<0.05. Results: 36% patients were below 40 years of age while 64% were above 40 years of age. Right sided hernia was more common with R:L ratio of 26:24. 34 cases had indirect and 16 had direct hernia. At baseline and one month follow up none of results were statistically significant while at 6 month follow up results were found significant with respect to development of chronic pain (p=0.007), pain after walking 3 flights of stairs (p=0.02) and pain after cycling for 10 minutes (p=0.021). Conclusion: Following Lichtenstein hernia surgery, preventive ilioinguinal neurectomy dramatically reduces the incidence of chronic groin discomfort without causing new morbidities. It ought to be viewed as a standard surgical procedure carried out during the procedure.