Chronic groin pain after open inguinal repair is hard to investigate when nobody knows which nerves were seen. Identify the ilioinguinal, iliohypogastric and genital branch of the genitofemoral nerve where possible, handle them gently, keep them away from the mesh edge and fixation sutures, and record in the operation note which were seen, preserved or divided. If a nerve is divided, cut it cleanly and bury the proximal end in muscle rather than leaving it under the mesh. That record is what a colleague will need if the patient returns with pain months later.
- Look for the ilioinguinal, iliohypogastric and genital branch nerves during open inguinal repair.
- Keep nerves clear of the mesh edge and fixation sutures.
- Record in the operation note which nerves were seen, preserved or divided.
- If dividing a nerve, cut cleanly and bury the proximal end in muscle.
Why it matters
Many trials did not report whether nerves were identified in the control arm, and routine operation notes often say no more.
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