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

25. Laparoscopic Triple Neurectomy
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of the genitofemoral nerve trunk (87.5 %). Importantly, it allows us to
more effectively treat inguinodynia following posterior repair (i.e., laparoscopic
TEP/TAPP), a subset of patients who do not respond as effectively
to open anterior triple neurectomy, as the pathology and site of
injury typically are proximal to the inguinal operative field.
With the minimally invasive approach, nerve identification, which is
often the cause for failure of open neurectomy, is uniformly successful;
the anatomy in the retroperitoneal lumbar plexus is less variable, and it
obviates the need to reoperate in a scarred field. Risks of remedial surgery
are reduced; morbidity and perioperative disability are minimized.
Thus, in the absence of recurrence or meshoma, this surgery is our preferred
technique for definitive management of chronic postherniorrhaphy
inguinodynia due to neuropathic causes.
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