Philip E George, Loic Tchokouani, Brian Jacob. Icahn School of Medicine at Mount Sinai
We present a case of a 56 year old female with a history of diabetes and hypertension who is status post a sleeve gastrectomy who presented to our clinic with both a Grynfelt hernia and umbilical/incisional hernia bulge. The Grynfelt hernia was repaired laparoscopically preperitoneally with a primary closure and overlying progrip mesh. The patient had severe postoperative pain that was neuropathic in nature and after conservative management and high suspicion that there was nerve entrapment by the primary repair we elected to take the patient to the operating room for exploration. We explored the patient laparoscopically and removed the primary closure suture and found the L1 nerve root which was likely caught in the repair. We left the progrip as a bridging mesh. The patient had a great decrease in the amount of pain she was feeling post operatively. One should always be suspicious of nerve entrapment in a patient with severe postoperative pain and dermatome distribution which gets worse after conservative measures.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93669
Program Number: V215
Presentation Session: Video Loop Day 1
Presentation Type: VideoLoop