Remedial robot-assisted laparoscopic surgery in the treatment of neuropathic inguinodynia and repair of inguinal hernia

Abstract

Introduction: Inguinodynia or persistent groin pain, is a common postoperative complication of inguinal hernia repair that may interfere with patients’ daily activities. Remedial surgery is often required for management. Based on our review of literature, the use of robotically assisted laparoscopy as an option for remedial surgery appears nonexistent. Case presentation: A 54-year-old male patient with a past history of inguinal hernia repair four years ago presented with severe, burning right inguinal pain that peaked 6 months prior to presentation. History was positive for failed multiple analgesic treatment options. Examination revealed tenderness over the right external ring and a prior right inguinal surgical incision with paresthesia along the distribution of the right ilioinguinal nerve. Based on the history and CT findings, the patient was diagnosed with meshoma and ilioinguinal nerve entrapment. Remedial posterior robotic laparoscopic surgery combined with ilioinguinal neurectomy was performed, resulting in complete resolution of pain post-operatively. Conclusions: In our case of post-inguinal hernia repair of neuropathic inguinodynia, laparoscopic robot-assisted surgery combined with ilioinguinal neurectomy led to excellent results.