Abdominal wall nerve injury during laparoscopic gynecologic surgery: incidence, risk factors, and treatment outcomes

Journal of Minimally Invasive Gynecology
Ja Hyun Shin, Fred M Howard

Abstract

To determine the incidence and clinical significance of iliohypogastric-ilioinguinal neuropathy from lower abdominal lateral port placement and fascial closure during laparoscopic gynecologic surgery. Retrospective cohort study (Canadian Task Force classification II-2). University-based referral center specializing in minimally invasive gynecologic surgery and chronic abdominopelvic pain. Women who underwent a laparoscopic procedure because of benign gynecologic indications during a 3-year study period from 2008 to 2011. A total of 317 women met study criteria. Operative laparoscopy using a lateral port in the lower abdomen. Closure of port-site fascial defects was achieved using either a Carter-Thomason or EndoClose suture device. Nerve injury was identified by symptoms, and was confirmed with a nerve block after a positive test for allodynia in the distribution of the iliohypogastric-ilioinguinal nerve. Of 173 cases that did not involve fascial closure of a port-site defect, none were associated with nerve injury. Of 144 cases that involved fascial closure, 7 (4.9%) included nerve injury that resulted in pain requiring treatment (p = .004). In 1 patient, symptoms improved with medical management alone. Six patients required s...Continue Reading

Associated Clinical Trials

References

Aug 1, 1994·The Journal of the American Association of Gynecologic Laparoscopists·F J MontzM Munro
May 8, 1998·Obstetrics and Gynecology·A M El-Minawi, F M Howard
Aug 2, 2002·Obstetrics and Gynecology·Richard J CardosiMitchel S Hoffman
Jan 8, 2004·American Journal of Obstetrics and Gynecology·James L WhitesideTommaso Falcone
Jul 23, 2005·Journal of Minimally Invasive Gynecology·Janie FullerJulia Carey-Corrado
Apr 2, 2008·Obstetrics and Gynecology·Maarten J LoosRudi M Roumen
Dec 22, 2009·American Journal of Obstetrics and Gynecology·David D RahnMarlene M Corton

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Citations

Feb 4, 2014·Clinical Obstetrics and Gynecology·Kelly R HodgesLaurie S Swaim
Sep 17, 2013·Journal of Minimally Invasive Gynecology·Stacey A ScheibAmanda N Fader
Aug 5, 2014·American Journal of Obstetrics and Gynecology·Stacey A Scheib, Amanda N Fader
Jun 28, 2014·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·D R BulianM M Heiss
Oct 21, 2016·Journal of Minimally Invasive Gynecology·Osama S AbdalmageedTommaso Falcone
Dec 29, 2016·Journal of Minimally Invasive Gynecology·Yolianne Lozada, Bala Bhagavath
May 4, 2017·Journal of the American Veterinary Medical Association·Danielle K MeremaMaureen A McMichael
Oct 14, 2017·ANZ Journal of Surgery·Nicholas Bell-AllenNicholas O'Rourke
Jun 9, 2016·Current Opinion in Obstetrics & Gynecology·Lisa Rogo-Gupta, Mario Castellanos
Apr 9, 2016·Annals of Surgery·Dirk R BulianKai S Lehmann
Oct 30, 2015·Clinical Obstetrics and Gynecology·Howard T Sharp
Oct 2, 2020·Skeletal Radiology·Steven P DanielsKenneth S Lee
Feb 3, 2016·World Journal of Urology·Panagiotis KallidonisEvangelos Liatsikos
Apr 5, 2020·American Journal of Obstetrics and Gynecology·Olivia O Cardenas-TrowersNicole R Herring

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