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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408 W.M.J. Reinpold and A.D. Schroeder Table 31.3. Triple neurectomy studies. Authors N Amid and Hiatt [ 5 ] 415 Sr 212 Mesh 195 Lap 8 Amid et al. [ 6 ] 16 Open Lap Primary surgery Pain surgery Neurectomy Campanelli et al. [ 24 ] 46 Open Open ant + post mesh Chen et al. [ 25 ] 20 Open 10 Lap 10 Mesh removal New mesh Pain relief Follow-up Open TNE No No Pain-free 85 % Improved 14 % Open Extended TNE Part. Me TNE 44 IHN 2 Yes 40/46 Lap Lapar. ERTNE No 18 Yes 2 (Me) Part. Me Yes 42/46 1 month 100% 6 months > 90 % PE and phone-Q (no data) Improved 14/16 4–6 weeks, PE (no data) Pain-free 40/46 Not improved 6/46 12 months (12–66 months) PE 100 % No Improved 20/20 22 weeks (16–40 weeks) PE Sr suture repair, Q questionnaire, PE physical examination, QL quality of life, TNE triple neurectomy, Lapar ERTNE retroperitoneoscopic triple neurectomy, Me meshoma
31. Triple Neurectomy Versus Selective Neurectomy 409 the cumulative data of three multiphase studies [ 2 –5 , 7 , 16 , 26 ], there remained 21 studies with 1035 patients. Ninety-three percent of neurectomies were performed after open inguinal hernia repair and 7 % after laparoscopic procedures [transabdominal preperitoneal repair (TAPP); totally extraperitoneal repair (TEP)]. Four studies with 497 patients reported on triple neurectomy [ 5 , 6 , 24 , 25 ] and 17 studies with 538 patients on selective neurectomy [ 2 , 8 –23 ]. The overall success rate (patients pain-free or pain improved) of neurectomy is 87 %, 77 % after selective neurectomy, and 98 % after triple neurectomy. The interpretation and comparison of the studies are limited due to different pre- and postoperative pain assessments; different type, duration, and percentage of follow-up; and limited reports on surgical complications. Eight studies did not report on early complications at all [ 4 –6 , 9 , 13 , 19 , 23 , 24 ]. Four trials assessed pain-related physical disabilities and restrictions of daily activities [ 2 , 7 , 12 , 17 ]. Three trials reported on pain during sexual activity [ 2 , 7 , 8 ]. Only seven studies included a workup of a multidisciplinary pain team [ 3 –6 , 10 , 17 , 25 ], and 12 publications integrated preoperative peripheral or paravertebral blocks in their study [ 8 , 10 , 11 , 13 , 16 –18 , 20 , 21 , 24 –26 ]. Fifty-nine (5.6 %) of the neurectomies were performed retroperitoneoscopically with a success rate of 80 % [ 17 , 25 ]. Patients do not seem to benefit from a general meshectomy. Table 31.4 [2 , 5 , 6 , 8 –25 ] shows the success rates of neurectomies with or without mesh removal. The Rationale of Selective Neurectomy Starling et al. [ 9 , 10 ] were the first to publish on neurectomy for the treatment of disabling chronic pain after open inguinal hernia repair. After a multidisciplinary approach with conservative pain treatment, as well as local blocks of the inguinal nerves and paravertebral blocks of L1 and L2, ilioinguinal and genitofemoral neuralgia were diagnosed in 19 and 17 patients, respectively. After a selective neurectomy of the entrapped portion of the ilioinguinal nerve (IIN), 17 patients were reported to be completely pain-free. Twelve patients improved after neurectomy of the entrapped genitofemoral nerve (GFN). The authors did not report on mesh removal, and there are no follow-up data in their publications. The selective neurectomy approach today is commonly used as an alternative to the triple neurectomy concept coined by Amid and colleagues in 2004 [ 4 ]. The aim of a selective neurectomy is to resect only
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Brian P. Jacob · David C. Chen Bru
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The SAGES Manual of Groin Pain Bria
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Foreword Inguinal hernia repair is
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Contents Part I Primary Groin Pain
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Contents ix 22 Management of Inguin
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Contents xi 45 Value-Based Clinical
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xiv Editors and Contributors Jeffre
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xvi Editors and Contributors David
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xviii Editors and Contributors Greg
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xx Editors and Contributors David S
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1. Introduction to Primary and Seco
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10 I.A. Gawlas and W.J. Peacock Ili
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12 I.A. Gawlas and W.J. Peacock Tra
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14 I.A. Gawlas and W.J. Peacock Var
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3. Complex Regional Pain Syndrome T
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4. Chief Complaint of Groin Pain: H
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4. Chief Complaint of Groin Pain…
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42 C. Ma and A. Ramaswamy inguinal
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44 C. Ma and A. Ramaswamy Categoriz
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46 C. Ma and A. Ramaswamy with no s
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48 C. Ma and A. Ramaswamy 26. Aasva
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50 I.M. Daoud and K. Dunn Other per
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52 I.M. Daoud and K. Dunn low herni
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54 I.M. Daoud and K. Dunn In the po
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56 I.M. Daoud and K. Dunn with a he
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58 I.M. Daoud and K. Dunn 13. O’C
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60 G.J. Mancini Occult Hernia Backg
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62 G.J. Mancini Magnetic resonance
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64 G.J. Mancini rocking motion can
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66 G.J. Mancini Unique to the adduc
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68 G.J. Mancini two nerve injuries
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70 G.J. Mancini abdominis has a rep
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72 G.J. Mancini 5. Light D, Ratnasi
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74 J.C. Campbell and G.D. Paiement
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9. Groin Pain Etiology: Spine and B
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10. Groin Pain Etiology: Spermatic
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Table 10.2. European Association of
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138 M. Hibner and C. Coyne Piriform
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140 M. Hibner and C. Coyne Fig. 11.
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142 M. Hibner and C. Coyne Table 11
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144 M. Hibner and C. Coyne present
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146 M. Hibner and C. Coyne Table 11
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148 M. Hibner and C. Coyne Once the
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150 M. Hibner and C. Coyne 3. Hibne
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12. Chronic Pelvic Pain in Women M.
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12. Chronic Pelvic Pain in Women 15
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174 J.M. Miller et al. Knowing the
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176 J.M. Miller et al. Fig. 13.2. A
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182 J.M. Miller et al. Fig. 13.9. C
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184 J.M. Miller et al. Fig. 13.14.
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192 J.M. Miller et al. Cardiac Cath
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194 B.J. Dunkin Noxious peripheral
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196 B.J. Dunkin Table 14.1. Summary
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198 B.J. Dunkin Rectus abdominis Ex
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200 B.J. Dunkin COX-1 COX-2 Celecpx
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202 B.J. Dunkin Table 14.2. Common
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204 B.J. Dunkin Possible Preoperati
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206 B.J. Dunkin Postoperative Pain
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208 B.J. Dunkin Summary Understandi
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15. Chronic Groin Pain Following An
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222 E.L. Felix not seem to alter th
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224 E.L. Felix nerves from the surg
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226 E.L. Felix Fig. 16.2. Lateral f
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228 E.L. Felix It has been establis
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230 E.L. Felix 18. Pollak R, Nyhus
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17. The Orthopedic Perspective on G
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246 J.F.M. Lange Jr. examination an
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248 J.F.M. Lange Jr. and remedial s
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250 J.F.M. Lange Jr. Best available
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252 J.F.M. Lange Jr. Neuropathic pa
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254 J.F.M. Lange Jr. This algorithm
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19. Radiologic Evaluation for Posto
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19 Radiologic Evaluation for Postop
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268 A. Malhotra extended variant of
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270 A. Malhotra steroid injections,
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272 A. Malhotra located just below
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274 A. Malhotra Nociceptive Acute N
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276 A. Malhotra 20. Rozen D, Parvez
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278 R. Álvarez intentionally or in
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Fig. 21.1. Material: A ballpoint pe
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Fig. 21.5. Dermatome mapping compat
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Fig. 21.9. Dermatome mapping compat
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286 R. Álvarez Subsequently, we mu
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288 R. Álvarez G : Granuloma H : H
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290 R. Álvarez Fig. 21.14. Same pa
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292 R. Álvarez 6. Lermite E, Arnau
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294 K.A. Seymour and J.S. Yoo Table
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296 K.A. Seymour and J.S. Yoo repro
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298 K.A. Seymour and J.S. Yoo Recur
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23. Mesh Removal for Chronic Pain:
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23. Mesh Removal for Chronic Pain
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320 I.T. MacQueen et al. inguinodyn
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322 I.T. MacQueen et al. Fig. 24.2.
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324 I.T. MacQueen et al. Timing and
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326 I.T. MacQueen et al. Fig. 24.4.
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328 I.T. MacQueen et al. Posthernio
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330 I.T. MacQueen et al. never be e
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25. Laparoscopic Triple Neurectomy
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26. Chronic Orchialgia: Workup and
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36. Sports Hernia with Adductor Ten
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464 C.G. DuCoin and G.R. Jacobsen P
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466 C.G. DuCoin and G.R. Jacobsen O
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468 J.A. Blatnik and A.S. Prabhu a
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470 J.A. Blatnik and A.S. Prabhu Fi
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472 J.A. Blatnik and A.S. Prabhu ma
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474 S. Towfigh Physical Exam The pa
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476 S. Towfigh The patient’s loca
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478 S. Towfigh Fig. 39.2. Diagram o
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480 S. Towfigh periphery. He is 2+
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482 S. Towfigh References 1. Matthi
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484 N.A. Al-Enazi and B.P. Jacob
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486 N.A. Al-Enazi and B.P. Jacob Fi
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488 N.A. Al-Enazi and B.P. Jacob pu
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42. Patient with Chronic Pelvic Pai
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42. Patient with Chronic Pelvic Pai
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43. Thoracolumbar Syndrome James A.
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43. Thoracolumbar Syndrome 497 The
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43. Thoracolumbar Syndrome 499 Groi
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44. Patient with Referred Hip Pain
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44. Patient with Referred Hip Pain
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45. Value-Based Clinical Quality Im
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46. Patient Care Manager Perspectiv
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47. Workers’ Compensation: An Occ
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532 Index Athletic pubalgia (cont.)
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534 Index Chronic post-herniorrhaph
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536 Index Groin pain (cont.) magnet
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538 Index Ilioinguinal nerve (IIN)
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540 Index Local anesthetics (cont.)
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542 Index Peripheral nerve entrapme
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544 Index S Sacroiliac (SI) joint d
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546 Index Transperineal pudendal ne
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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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