Douglas Fenton-Lee, MB, BS, FRACS1, John Garvey, BSc, MB, BS, DPhil, FRACS, FACS, CIME2, Kurt Verscheur, MB, BS, FRACS1, John Read, MB, BS, FRANZCR, DDU3. 1St Vincents Hospital, Sydney, 2Groin Pain Clinic, 3Castlereagh Sports Imaging
Inguinodynia following laparoscopic hernia repair is thought to occur in X% of patients. The majority of patients with severe pain are managed conservatively with analgesia and neuomodulators prescribed by practitioners working in "pain clinics" with varying success.
The aim of managing these patients is to improve their quality of life and in some instances enabe them to return to normal activity.
The work up of these patients requires a thorough history, clinical examination and musculoskeletal imaging.
Even after such investigation the only option left is removal of the mesh and tacs.
We have laparoscopically removed 6 meshes and tacs with no sgnificant morbidity. All patients have had a significant clinical improvement of their pain. We have not performed neurectomy or placed another mesh at the time of mesh explantation.
Laparoscopic mesh removal for inguinodynia can be performed with minimal morbidity. We believe that this should be offered to patients who suffer inguinodynia as it will allow patients to be managed with less medication.