Skip to main content

Advertisement

Log in

The femoral nerve in the repair of inguinal hernia: well worth remembering

  • Case Report
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

Injury to the nerves after inguinal hernia surgery is uncommon. The femoral nerve may be damaged by suture or staples, tissue scar entrapment, local anesthesia blockade or direct compression. We present a case of a transient lesion of the femoral nerve after mesh hernioplasty for a re-recurrent inguinal hernia, confirmed by radiological studies, electrophysiology and clinical recovery. The diagnosis, mechanism of injury and surgical approach are reviewed. Surgery to a recurrent hernia may be underestimated. The role of electromyography nerve conducting studies is emphasized insisting on the importance of clinical evolution for the successful management of these infrequent injuries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Pozzati E, Poppi M, Galassi E (1982) Femoral nerve lesion secondary to inguinal herniorrhaphy. Int Surg 67:85–86

    PubMed  CAS  Google Scholar 

  2. Keating JP, Morgan A (1993) Femoral nerve palsy following laparoscopic inguinal herniorrhaphy. J Laparoendosc Surg 3:557–559

    PubMed  CAS  Google Scholar 

  3. Celdran A, Vorwald P, Merono E, Urena MA (1992) A single technique for polypropylene mesh hernioplasty of inguinal and femoral hernias. Surg Gynecol Obstet 175:359–361

    PubMed  CAS  Google Scholar 

  4. Amid PK (2004) Lichtenstein tension-free hernioplasty: its inception, evolution, and principles. Hernia 8:1–7

    Article  PubMed  Google Scholar 

  5. Celdran A, Bazire P, Garcia Urena MA, Marijuan JL, Mateo A (1994) Anterior approach for mesh repair of inguinofemoral hernia after obliteration of the inguinal ligament. Br J Surg 81:572–573

    Article  PubMed  CAS  Google Scholar 

  6. Kim DH, Kline DG (1995) Surgical outcome for intra- and extrapelvic femoral nerve lesions. J Neurosurg 83:783–790

    PubMed  CAS  Google Scholar 

  7. Busis NA (1999) Femoral and obturator neuropathies. Neurol Clin 17:633–53

    Article  PubMed  CAS  Google Scholar 

  8. Nobel W, Marks SC Jr, Kubik S (1980) The anatomical basis for femoral nerve palsy following iliacus hematoma. J Neurosurg 52:533–540

    Article  PubMed  CAS  Google Scholar 

  9. Natelson SE (1997) Surgical correction of proximal femoral nerve entrapment. Surg Neurol 48:326–329

    Article  PubMed  CAS  Google Scholar 

  10. Stoppa RE (1998) Hernia of the abdominal wall. In: Chevrel JP (ed) Hernias and surgery of the abdominal wall. Springer, Berlin Heidelberg New York, pp 233–241

    Google Scholar 

  11. Schottland JR (1996) Femoral neuropathy from inadvertent suturing of the femoral nerve. Neurology 47:844–845

    PubMed  CAS  Google Scholar 

  12. Chevallier JM, Wind P, Lassau JP (1996) Damage to the inguino-femoral nerves in the treatment of hernias. An anatomical hazard of traditional and laparoscopic techniques. Ann Chir 50:767–775

    PubMed  CAS  Google Scholar 

  13. Greig JD, McArdle CS (1994) Transient femoral nerve palsy complicating preoperative ilioinguinal nerve blockade for inguinal herniorrhaphy. Br J Surg 81:1829

    Article  PubMed  CAS  Google Scholar 

  14. Lange B, Langer C, Markus PM, Becker H (2003) Paralysis of the femoral nerve following totally extraperitoneal laparascopic inguinal hernia repair. Surg Endosc 17:1156–1157

    Article  Google Scholar 

  15. Kline DG (1972) Operative management of major nerve lesions of the lower extremity. Surg Clin North Am 52:1247–1265

    PubMed  CAS  Google Scholar 

  16. Kingsnorth AN, Skandalakis PN, Colborn GL, Weidman TA, Skandalakis LJ, Skandalakis JE (2000) Embryology, anatomy, and surgical applications of the preperitoneal space. Surg Clin North Am 80:1–24

    Article  PubMed  CAS  Google Scholar 

  17. Beets GL, Dirksen CD, Go PM, Geisler FE, Baeten CG, Kootstra G (1999) Open or laparoscopic preperitoneal mesh repair for recurrent inguinal hernia? A randomized controlled trial. Surg Endosc 13:323–327

    Article  PubMed  CAS  Google Scholar 

  18. Stoppa RE (2003) Wrapping the visceral sac into a bilateral mesh prosthesis in groin hernia repair. Hernia 7:2–12

    PubMed  Google Scholar 

  19. Nyhus LM (2003) The posterior (preperitoneal) approach and iliopubic tract repair of inguinal and femoral hernias - an update. Hernia 7:63–67

    Article  PubMed  Google Scholar 

  20. Barrat C, Surlin V, Bordea A, Champault G (2003) Management of recurrent inguinal hernias: a prospective study of 163 cases. Hernia 7:125–129

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. A. García-Ureña.

Rights and permissions

Reprints and permissions

About this article

Cite this article

García-Ureña, M.A., Vega, V., Rubio, G. et al. The femoral nerve in the repair of inguinal hernia: well worth remembering. Hernia 9, 384–387 (2005). https://doi.org/10.1007/s10029-005-0327-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-005-0327-9

Keywords

Navigation