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 space. For previous laparoscopic repairs and for those
open repairs that result in mesh placement in the preperitoneal space,
this may be all that is required to achieve maximal improvement from an
operation. For most open inguinal hernia repair techniques, an additional
open groin incision may be necessary to achieve maximal improvement
from an operation. Removal of all foreign body materials and division
and/or lysis of all involved nerves with a three-layer groin closure using
absorbable suture can be accomplished through the open groin incision.
Even when the original cause of the pain has been successfully eliminated
at operation, complete pain relief may not be achieved and additional
pain management may be required. Because of the complexity of
this problem and the psychological and emotional impact that can occur,
this problem is best addressed by a multidisciplinary team.
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