Nerve Injury

Pain and paresthesias in the inguinal region were not uncommon after the early reports of laparoscopic hernia repair because of the initial unfamiliarity of the course of these nerves and the greater number of tacks to fixate the mesh (10). Careful attention to the anatomy of these nerves and reduction in the number of tacks used to fix the mesh to the transversalis fascia have decreased the incidence of these nerve injuries.

Avoidance of tack placement below the iliopubic tract and constant palpation of the tacker against the abdominal wall will ensure correct placement of tacks. However, if nerve entrapment occurs in the immediate postoperative period, the patient should be brought back to the operating room for tack removal.

Table 3 shows the nerves involved in hernia repair and the potential postoperative symptoms of nerve injury.

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