Mesh Removal Versus No Mesh Removal for Chronic Groin Pain After Minimally Invasive Inguinal Hernia Repair: A Randomized Controlled Trial
This study is evaluating the management of chronic post-operative inguinal hernia pain and the impact of hernia mesh removal after previous minimally invasive inguinal hernia repairs. The study aims are to evaluate the change in chronic (\>6 months), nociceptive, postoperative inguinal pain after mesh removal compared to no mesh removal in patients who have previously undergone minimally invasive inguinal hernia repair with pre-peritoneal mesh.
⁃ \> 18 years of age
⁃ CPIP lasting \> 6 months after laparoscopic or robotic inguinal hernia repair with pre-peritoneal mesh
⁃ Must exhibit 1 or more of the following characteristics of nociceptive pain:
∙ History:
⁃ Pain while sitting in a chair for prolonged periods of time with relief when extending the hip or lying supine to straighten the leg
⁃ Severe pain when crossing the affected leg over the contralateral leg
⁃ Foreign body sensation or tightness in the groin
∙ Exam:
• Diffuse tenderness with deep palpation along the inguinal ligament (over the mesh)
∙ Somatosensory mapping:
⁃ Does not have a maximum trigger point for pain
⁃ Lacks characteristics of neuropathic pain (sharp, burning, shooting, paresthesias, allodynia, hyperalgesia, etc.)
‣ Moderate to severe pain \[4-10\] when moving from supine to standing on NRS