A patient develops severe chronic groin pain after open inguinal hernia repair unresponsive to conservative treatment, and a planned triple neurectomy is undertaken. Which three nerves are divided?

• A Ilioinguinal, lateral femoral cutaneous, and obturator nerves
• B Ilioinguinal, iliohypogastric, and genital branch of the genitofemoral nerve ✓
• C Femoral branch of genitofemoral, pudendal, and iliohypogastric nerves
• D Obturator, genital branch of genitofemoral, and subcostal nerves

Explanation

The triple neurectomy divides all three nerves at risk during inguinal herniorrhaphy: the ilioinguinal and iliohypogastric nerves running in the canal, and the genital branch of the genitofemoral nerve accompanying the spermatic cord. These supply the groin and scrotal/labial skin, and their entrapment in sutures or scar causes refractory postoperative neuralgia. The lateral femoral cutaneous nerve passes near the ASIS far from the field, and the pudendal nerve is not encountered in inguinal dissection.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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