A 46-year-old man had persistent inguinodynia two years following open tension free (Lichtenstein) mesh repair on the left. Pain management failed to alleviate the pain. Nerve block localized the pain to the ilioinguinal nerve. The patient was taken to the operating room for ilioinguinal neurectomy.
Under local anesthesia a three-centimeter incision was made at the lateral end of the prior incision and external oblique was opened. The ilioinguinal nerve was mobilized from the surface of the internal oblique muscle and segment was resected. The specimen was sent for pathology. The nerve ends were tied with 4-0 monofilament absorbable ligature and the proximal end was buried in the internal oblique muscle. At two weeks the patient was relieved of 90% of the previous pain.
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