Chronic Postoperative Pain After Primary Inguinal Hernia Repair and the Role of Triple Neurectomy

Background Inguinal hernia repair is one of the most common surgical procedures worldwide. The chronic postoperative pain, defined as pain lasting more than 3 months, is currently one of the most feared complications, with up to 5–0% occurence rate after primary inguinal hernia repair. Case Report We present two male patients with chronic postoperative pain after open and laparoscopic hernioplasty with mesh, respectively. After failed conservative therapy and careful diagnostics including magnetic resonance and ultrasound guided block of iliohypogastric and ilioinguinal nerves, both patients were scheduled for laparoscopic triple neurectomy. Surgeries were uneventful and nerves were verified by histopathological examination. Results Both patients reported a significant reduction of pain on the first postoperative day and then one month and one year postoperatively. Both patients reported a better quality of life after the surgery and a return to normal daily activities. Conclusion Postoperative pain after inguinal hernia repair should be continuously discussed and researched topic among general surgeons given the frequency of the procedure. We discuss the problematics of chronic inguinal pain including diagnostic algorithm, treatment and the necessary multidisciplinary approach to the patient with chronic inguinal pain. We also present triple neurectomy as a last resort modality, desciribing the surgery (open vs. laparoscopic), its advantages and disadvantages.