LAUSR

It is recommended to identify nerves in the surgical field during open inguinal hernioplasty. This ensures proper dissection and reduces the incidence of post-operative inguinodynia. From limited surgical studies, it appears that identifying nerves may not be possible in all cases. Little is known about the factors that affect their identification. We conducted a cross-sectional study on thirty-six male patients with primary inguinal hernia. We looked for the nerves during Lichtenstein hernioplasty. We collected data on the identification & preservation of nerves for calculating the nerve identification rates. We observed the course of the nerves and evaluated the effect of BMI, height, anaesthesia type, surgical experience, ASA, type of hernia and sac contents on nerve identification. Ilioinguinal nerve (IIN), Iliohypogastric Nerve (IHN), and Genital branch of genitofemoral nerve (GBN) were identified in 86.1%, 75%, and 50% of the groin dissections. It was easier to identify the IIN when the omentum was the content of the sac. The IHN was easily identified in patients with BMI ≤ 25 kg/m2. Nerve identification can be challenging during surgery. The GBN and IHN are more prone to dissection-related injuries. Identification of IHN and IIN is difficult in overweight individuals and cases where hernia contains bowel.