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

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L.A. Cunningham and B. Ramshaw
Preperitoneal Mesh:
• Lateral femoral
cutaneous
• Femoral branch of the
genitofemoral
• Genital branch of the
genitofemoral
Lichtenstein mesh
placement:
• Iliohypogastric
• Ilioinguinal
• Genital branch
of the genitofemoral
Fig. 23.2. Mesh placement (preperitoneal and Lichtenstein) and the nerves
potentially at risk for the left groin.
additional or new pain from a mesh and/or from mesh fixation, when the
goal of the operation is to relieve pain. The exception to this is when an
interstitial or recurrent hernia is found at laparoscopy. If a hernia defect
is identified after a laparoscopic mesh removal, a laparoscopic primary
suture repair is performed. For all procedures that include open mesh
removal, a three-layer groin reconstruction is performed using absorbable
sutures.
Postoperative Management
The patient is often discharged the same day or within 24–48 h of the
operation, unless there are complications. However, for patients on high
dosages of opioid agonists, a longer hospital stay for pain control and
monitoring may be required. In this early postoperative period, the initial
treatment of pain is identical to the treatment of nonsevere or acute
groin pain and includes rest, ice, and/or heat to the groin, antiinflammatory
medication, and a mild narcotic medication. A bowel