During laparoscopic totally extraperitoneal (TEP) inguinal hernia repair, injury to which nerve running beneath the iliopubic tract causes numbness over the scrotum and proximal medial thigh?
- A Ilioinguinal nerve
- B Lateral femoral cutaneous nerve
- C Genitofemoral nerve — genital branch ✓
- D Femoral nerve
Correct answer: C. Genitofemoral nerve — genital branch
Explanation
During TEP/TAPP, mesh fixation lateral to the inferior epigastric vessels risks injury to the genital branch of the genitofemoral nerve (running beneath the iliopubic tract), which supplies sensation to the scrotum/labium majus and proximal medial thigh. The ilioinguinal nerve is at risk in open Lichtenstein repair as it runs through the inguinal canal. The lateral femoral cutaneous nerve runs lateral near the anterior superior iliac spine. A 'pain triangle' (below the iliopubic tract) is avoided during fixation to prevent these injuries.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.