Thursday, 18 September 2008

Laparoscopic inguinal ligament tenotomy and mesh reinforcement of the anterior abdominal wall: a new approach for the management of chronic groin pain

Surg Laparosc Endosc Percutan Tech. 2008 Aug;18(4):363-8.

Lloyd DM, Sutton CD, Altafa A, Fareed K, Bloxham L, Spencer L, Garcea G.

Department of Laparoscopic and Upper Gastrointestinal Surgery, The Leicester Royal Infirmary, Leicester.

BACKGROUND: Chronic groin pain has an incidence of up to 6.2% and is common in people undertaking regular sports activity. A variety of surgical options exist for unresolving pain, which consist, for the most part, of a repair of the posterior abdominal wall, with or without mesh placement. We describe a new technique, which combines laparoscopic inguinal ligament tenotomy in conjunction with a mesh repair. METHODS: A retrospective analysis of the notes of 48 patients was undertaken in conjunction with a mailed questionnaire. Success of surgery was judged on return to preinjury sporting activity, severity of pain scores, frequency of pain scores, and functional limitation scores. RESULTS: There were no major complications associated with the procedure. Severity of pain, frequency of pain, and functional limitation scores were all significantly improved after surgery (P=0.0012, <0.0001, and <0.0001, respectively). Ninety-two percent of patients polled returned to normal sports activity after their surgery (n=24). The median return to strenuous sports activity was 28 days (range of 14 to 40 d). CONCLUSIONS: The success rates of laparoscopic tenotomy and mesh repair are comparable with the published literature and a lower median time interval before returning to preinjury sporting activity.

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