Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

16. Chronic Groin Pain Following
Posterior Hernia Surgery
Edward L. Felix
Introduction
Today most posterior inguinal hernia repairs are performed laparoscopically,
but the origin of this approach dates back to Annandale [ 1 ]
in 1876 with the first published report of an open posterior approach to
the hernia sac. The approach was slow to gather attention until Cheatle
(1921) [ 2 ] and later Henry (1936) [ 3 ] suggested it might be used for both
femoral and inguinal hernias. It was not until 1959, however, that Nyhus
[ 4 ] began to popularize an open posterior primary repair of hernia
defects. Mesh soon became a staple of the repair as patch reinforcement,
but with further refinements by Rignault [ 5 ], Stoppa [ 6 ], and later Wantz
[ 7 ], the patch was replaced by a large or sometimes giant mesh covering
the entire posterior floor.
Using the principles of the open posterior approach, a laparoscopic
approach was born in the early 1990s with the birth of advanced laparoscopic
techniques [ 8 – 10 ]. Two distinct approaches were successfully
developed, the transabdominal preperitoneal (TAPP) and the totally
extraperitoneal (TEP) . Both approaches utilize a large mesh covering
all three potential defects. The techniques have been modified over
time, and the use of fixation and mesh type continue to be debated and
will be discussed later in the chapter.
Results of laparoscopic approaches have now been extensively studied
in both retrospective and prospective randomized reports [ 11 – 14 ]. In
the hands of experienced laparoscopic surgeons, recurrence rates are
equal or lower than open anterior approaches, but long-term chronic
pain is reduced by the laparoscopic approach when compared to anterior
open approaches [ 15 – 17 ]. Whether ( TAPP or TEP) approach is used does
© Springer International Publishing Switzerland 2016
B.P. Jacob et al. (eds.), The SAGES Manual of Groin Pain,
DOI 10.1007/978-3-319-21587-7_16
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