International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery
Source: Hernia, Volume 15, Number 3, June 2011 , pp. 239-249(11)
Abstract:To provide uniform terminology and definition of post-herniorrhaphy groin chronic pain. To give guidelines to the scientific community concerning the prevention and the treatment of chronic groin and testicular pain.
A group of nine experts in hernia surgery was created in 2007. The group set up six clinical questions and continued to work on the answers, according to evidence-based literature. In 2008, an International Consensus Conference was held in Rome with the working group, with an audience of 200 participants, with a view to reaching a consensus for each question.
A consensus was reached regarding a definition of chronic groin pain. The recommendation was to identify and preserve all three inguinal nerves during open inguinal hernia repair to reduce the risk of chronic groin pain. Likewise, elective resection of a suspected injured nerve was recommended. There was no recommendation for a procedure on the resected nerve ending and no recommendation for using glue during hernia repair.
Surgical treatment (including all three nerves) should be suggested for patients who do not respond to no-surgery pain-management treatment; it is advisable to wait at least 1 year from the previous herniorraphy.
The consensus reached on some open questions in the field of post-herniorrhaphy chronic pain may help to better analyze and compare studies, avoid sending erroneous messages to the scientific community, and provide some guidelines for the prevention and treatment of post-herniorraphy chronic pain.
Document Type: Research Article
Affiliations: 1: Department of Digestive Surgery, Catholic University of the Sacred Heart, Largo A. Gemelli, 8, 00168, Rome, Italy, Email: email@example.com 2: Department of Surgery, UCLA Medical Center, Lichtenstein Hernia Institute at University of California Los Angeles, Los Angeles, CA, USA 3: Department of Surgery, University of Insubria, Varese, Italy 4: Service de Chirurgie Digestive, Centre Hospitalier de Bigorre, Boulevard de Lattre de Tassigny, Tarbes Cedex, France 5: Section for Surgical Pathophysiology, Rigshospitalet Copenhagen University, Copenhagen, Denmark 6: Department of Surgery, Erasmus Medical Centre, University Medical Centre, Rotterdam, The Netherlands 7: Department of Digestive Surgery, Catholic University of the Sacred Heart, Largo A. Gemelli, 8, 00168, Rome, Italy
Publication date: 2011-06-01