IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 1 Ser. 9 (January. 2019), PP 42-46 www.iosrjournals.org DOI: 10.9790/0853-1801094246 ww.iosrjournals.org 42 | Page A Study for Short Term Neurosensory Effects of Prophylactic Ilioinguinal Neurectomy during Lichtenstein Repair of Inguinal Hernia. Som Raj Mahajan 1 , Ankur Sharma 2 , Sanjeev Sharma 3 , Monika Mahajan 4* , Amit Bhardwaj 4 . 1,2,3 Department of Surgery, Dr. Rajendra Prasad Govt. Medical College, Tanda, Kangra, HP, India. 4, Department of Anaesthesia, Dr. Rajendra Prasad Govt. Medical College, Tanda, Kangra, HP, India. 5, Department of Neurology, Dr. Rajendra Prasad Govt. Medical College, Tanda, Kangra, HP, India. Address Senior Resident, Deptt. Of Anaesthesia,Dr. Rajendra Prasad Govt. Medical College, Tanda, Kangra, HP, India. Corresponding Author: Dr. Monika Mahajan Abstract: Chronic inguinodynia is one of the major problem arising after mesh hernioplasty leading to patient discomfort.The mechanism seems to be injury by suture, adherence to overlying implanted mesh, or involvement by scar tissue. Ilio-inguinal neurectomy during Lichtenstein hernioplasty may offers prophylaxis to such devastating pain. Our study aims to study the short term neurosensory effects of prophylactic ilioinguinal neurectomy during Lichtenstein repair of inguinal hernia. Methods and Material: This prospective observational study was conducted in thirty male patients aged 18-80 years who presented with inguinal hernia for elective Lichtenstein hernia repair. Postoperatively patients were assessed for pain, temperature, tactile sensation and numbness on day1, 7 and 30 after surgery. Severity of pain was assessed by Visual Analogue Scale. Results: Postoperatively mild pain was observed in 19(63.33%) patients and moderate pain was observed in11(36.63%) on day 1 post neurectomy. At 1 month post surgery 3(9.99%) patient complained of mild pain in groin region. There was no loss of temperature and pain sensation in any patient. Three (9.99%) patients experienced loss of touch sensation in the area of supply of ilioinguinal nerve on Semmes-Weinstein Monofilament (SWM) test, at post operative day 1 and 7. Out of which 2 patients regained their sensation to touch while one patient had persistent loss of sensation. Conclusion: prophylactic neurectomy of the inguinal nerves at the time of herniorrhaphy may decrease the incidence of post incisional neuropathy. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 04-01-2019 Date of acceptance: 19-01-2019 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Lichteinstein hernia repair is one of the commonest operation performed worldwide for inguinal hernias. Chronic inguinodynia is one of the major problem arising after mesh hernioplasty with incidence ranging from 19.0% to 62.9%. [1] These patients usually present with groin pain for varying length of time. While most patients report pain immediately after their inguinal operation, a delay in onset of symptoms from a few weeks to several years is seen in some cases. The most frequently entrapped nerves are ilioinguinal and iliohypogastric. The mechanism seems to be injury to nerves by suture, adherence to overlying implanted mesh, or involvement by scar tissue.Chronic inguinodynia may impact patient satisfaction, society cost and overall quality of life of patient. lIlio-inguinalneurectomy during Lichtenstein hernioplasty may offers prophylaxis to such devastating pain. The most successful method available to relieve post incisional pain is surgical resection of the involved nerves with reasonably good long-term pain relief. It is occasionally stated that prophylactic neurectomy of the inguinal nerves at the time of herniorrhaphy, especially with mesh prostheses, will prevent post incisional neuropathy. But the neurectomized patients frequently developed annoying and occasionally disabling numbness. This is not a frequent complaint when neurectomies are done for pain symptoms, since most, if not all, patients are happy to trade numbness for pain relief. [2] II. Subjects and Methods After approval from the institutional ethics committee the prospective observational study included thirty male patients aged 18-80 years presenting with inguinal hernia which were hospitalized for elective Lichtenstein hernia repair.The female patients, irreducible or strangulated hernias (complicated hernias), patients who were previously operated for contralateral hernia, recurrent hernias, previous history of abdominal