A 62-year-old man with a direct inguinal hernia undergoes mesh plug repair. Postoperatively, he complains of persistent groin discomfort and a sensation of 'pulling' on coughing. Which nerve is most commonly implicated in chronic post-hernia repair pain when the mesh plug causes fibrosis around it?

• A Femoral nerve
• B Lateral cutaneous nerve of thigh
• C Obturator nerve
• D Ilioinguinal nerve ✓

Explanation

The ilioinguinal nerve is the most commonly injured nerve during open inguinal hernia repair and the most frequent source of chronic postoperative groin pain. It runs through the inguinal canal and is vulnerable during mesh or plug fixation, particularly at the pubic tubercle. The lateral cutaneous nerve of thigh is more commonly injured in laparoscopic repairs at the level of the triangle of pain.

Reference: Schwartz's Principles of Surgery, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.