Prospective study of the neurotopographic adequacy of transverse incision in Lichtenstein inguinal hernioplasty.

Abstract

Lichtenstein technique requires identification of the iliohypogastric, ilioinguinal, and genital branch of the genitofemoral nerves.The aim of the study was to verify if the transverse incision is suitable for identification of the iliohypogastric, ilioinguinal, and genital branch of the genitofemoral nerves.This study included 29 patients who underwent hernioplasty, and also 10 dissections of the inguinal regions from 5 cadavers. The anthropometric measurements included: incision size (IS) and topography, pubic angle (PA), body mass index (BMI), and the distance from the pubis to the incision and bi-iliac crest plane. The correlations between variables of interest and the ability to identify the nerves were assessed.Measures of height (P = 0.108), BMI (P = 0.343), and abdominal circumference (AbC) (P = 1.000); the correlations between incision IS and PA (r = −0.17, P = 0.406), IS and BMI (r = 0.56, P = 0.002), IS and AbC (r = 0.56, P = 0.002); incision and pubic heights (r = −0.26, P = 0.174); patient height and PA (r = −0.33, P = 0.092). The associations between these measures were: BMI (P = 0.136), AbC (P = 0.104), PA (P = 0.641), and IS (P = 0.399). The rates of successful nerve identification in patients and corpse were: iliohypogastric—29 (29)/9 (10), 100% (P = 0.147); ilioinguinal—29 (29)/10 (10), 100%; and genital branch of the genitofemoral nerve—26 (29)/9 (10), 89.7/80% (P = 0.488).The transverse incision permitted identification of the nerves for Lichtenstein hernioplasty.