Evidence map›Paper›PMID 31776877›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2020

The inguinal region revisited: the surgical point of view : An anatomical-surgical mapping and sonographic approach regarding postoperative chronic groin pain following open hernia repair.

M Konschake, M Zwierzina, B Moriggl, R Függer, F Mayer, W Brunner, T Schmid, D C Chen, R Fortelny

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In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 35 citations in OpenAlex.

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  15. Neuropathic inguinal pain due to nerve injury after a laparoscopic appendectomy: first pediatric case described in the literature.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 3 countries.

M KonschakeDepartment of Anatomy, Histology and Embryology, Division of Clinical and Functional Anatomy, Medical University of Innsbruck, Müllerstr. 59, 6020, Innsbruck, Austria. marko.konschake@i-med.ac.at.ORCID 0000-0002-9706-7396
M ZwierzinaDepartment of Plastic, Reconstructive and Aesthetic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria.
B MorigglDepartment of Anatomy, Histology and Embryology, Division of Clinical and Functional Anatomy, Medical University of Innsbruck, Müllerstr. 59, 6020, Innsbruck, Austria.
R FüggerDepartment of Surgery, Elisabethinen Hospital, Linz, Austria.
F MayerDepartment of Surgery, Paracelsus Medical University, Salzburg, Austria.
W BrunnerDepartment of Surgery, Kantonspital St. Gallen, St. Gallen, Switzerland.
T SchmidDepartment for Visceral-, Transplantation- and Thoracic Surgery, Center of Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria.
D C ChenDepartment of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
R FortelnyDepartment of General-, Visceral- and Oncological Surgery, Wilhelminenspital, Vienna, Austria.
Innsbruck Medical University · ATKantonsspital St. Gallen · CHKrankenhaus der Elisabethinen · ATParacelsus Medical University · ATUniversity of California, Los Angeles · USWilhelminen Hospital · AT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeInguinodynia or chronic post-herniorrhaphy pain, defined as pain lasting longer than 3 months after open inguinal hernia repair, has become the most important complication after inguinal surgery and therefore compromises the patient´s quality of life. A major reason for inguinodynia might be the lack of neuroanatomical knowledge and suboptimal "management" of the nerves during surgery.

methodsWe present a detailed neuroanatomic mapping of the inguinal region by dissection including the most important surgical landmarks with all nerves confirmed by immunohistochemistry, ultrasound guided visualization of the iliohypogastric, ilio-inguinal, and genital branch of the genitofemoral nerve, and a practical (preoperative) algorithm for clinical management.

resultsSurgically and ultrasonographically relevant structures ("landmarks") in open hernia repair are the anterior-superior iliac spine, pubic tubercle, Camper´s fascia (superficial layer of the superficial abdominal fascia), External oblique aponeurosis, Internal oblique muscle, Transversus abdominis muscle, superficial inguinal ring, external spermatic fascia, cremasteric fascia with cremaster muscle fibers, internal spermatic fascia, cremasteric vein (=external spermatic vein = "blue line"), ductus deferens, pampiniform plexus, inguinal ligament and the inferior epigastric vessels.

conclusionA detailed understanding of inguinal anatomy is an indispensable basic requirement for all surgeons to perform inguinal ultrasonography as well as open inguinal hernia repair, avoiding complications, especially postoperative inguinodynia.

Indexed as

FemaleGroinHernia, InguinalHerniorrhaphyHumansMalePostoperative PainQuality of LifeUltrasonographyChronic groin painInguinal nervesInguinodyniaOpen hernia repairUltrasound

Identifiers

PMID31776877
PMCPMC7395915
OpenAlexW2990250923

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.