Laparoscopic Exploration and Psoas implantation of the Genitofemoral Nerve for Post-herniorrhaphy Neuralgia

Peter S Wu, MD, Jennifer A McLellan, MD, Pranay M Parikh, MD, John R Romanelli, MD

Baystate Medical Center

Inguinodynia after inguinal hernia repair is a difficult clinical problem that has been gaining increasing recognition. Amongst the commonly involved nerves, the anatomic course of the genitofemoral nerve as it travels along the psoas muscle lends itself in particular to laparoscopic intervention. We submit a video of a patient suffering from debilitating pain in the genitofemoral distribution after a totally extraperitoneal inguinal hernia repair for recurrence following a remote open herniorraphy. In the video, we demonstrate laparoscopic transabdominal preperitoneal exploration, identification and isolation of the nerve along the psoas, and liberalization of the nerve from the offending piece of mesh. The nerve stump was laparoscopically implanted into the psoas muscle as is congruent with the principles of peripheral nerve surgery performed for neuropathic pain syndromes. Postoperatively the patient had lasting resolution of his pain.


Session: Podium Presentation

Program Number: V027

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