La lesion du nerf crural compliquant les cures des hernies de l'aine par plaque pre'-pe'ritone'ale. Apropos de 2 observations

ABSTRACT

Between January 1995 and September 1997, 83 patients having bilateral inguinal and/or crural hernia underwent. a prosthetic herniorrhaphy which is complicated in two cases by an iatrogenic lesion of the crural nerve. Reoperation was required in both of cases. In the first case [of late diagnosis], there is a fibrosis around the mesh sheathing the crural nerve. The follow up was favourable after neurolisis. The second patient was reoperated in the immediate postoperative period. The crural nerve was picked up by the mesh side fixing knot. The follow up was also favourable after neurolisis. The crural nerve iatrogenic lesion occurring during the groin hernia repair with a wide preperitoneal prosthesis must be prevented by a vigorous operative procedure particularly at the time of side attaching of the mesh. This side securing of the mesh is unnecessary. The arising of a pain or a leg functional disability during the post operative period must evoke a crural nerve lesion, and lead to a surgical exploration