Abstract：
BACKGROUND: Chronic pain after minimally invasive inguinal hernia repair with mesh can have debilitating effects on quality of life (QOL), limiting daily activities and ability to work. Many medical and surgical options for treatment have been proposed, however there is no consensus on the role of mesh explantation in the management of these patients.
METHODS: We performed a retrospective review of all patients who underwent groin mesh removal by robotic or laparoscopic approach from July 2012 to July 2023 at our institution. Patients were interviewed post-operatively to determine their overall pain scores and QOL was assessed using the Carolinas Comfort Scale (CCS) Questionnaire. Patient characteristics, operative times, pre-operative imaging techniques and analgesia use was also recorded.
RESULTS: Twenty-two patients underwent groin mesh removal for chronic pain, including 12 robotic and 10 laparoscopic operations. The mean pre-operative pain score in all patients was 7.6/10 compared to 4.0/10 post-operatively. The mean post-operative CCS score was 24, indicating moderate discomfort. Four patients demonstrated CCS scores <11 indicating no discomfort and no patients demonstrated CCS scores >90, indicating severe debilitating discomfort. The majority of patients had a reduction or total cessation of analgesia intake post-operatively.
CONCLUSIONS: Both laparoscopic and robotic mesh explantation for treatment of chronic pain post-inguinal hernia repair is safe and effective in achieving a reduction in pain and reducing the need for long-term analgesia.
METHODS: We performed a retrospective review of all patients who underwent groin mesh removal by robotic or laparoscopic approach from July 2012 to July 2023 at our institution. Patients were interviewed post-operatively to determine their overall pain scores and QOL was assessed using the Carolinas Comfort Scale (CCS) Questionnaire. Patient characteristics, operative times, pre-operative imaging techniques and analgesia use was also recorded.
RESULTS: Twenty-two patients underwent groin mesh removal for chronic pain, including 12 robotic and 10 laparoscopic operations. The mean pre-operative pain score in all patients was 7.6/10 compared to 4.0/10 post-operatively. The mean post-operative CCS score was 24, indicating moderate discomfort. Four patients demonstrated CCS scores <11 indicating no discomfort and no patients demonstrated CCS scores >90, indicating severe debilitating discomfort. The majority of patients had a reduction or total cessation of analgesia intake post-operatively.
CONCLUSIONS: Both laparoscopic and robotic mesh explantation for treatment of chronic pain post-inguinal hernia repair is safe and effective in achieving a reduction in pain and reducing the need for long-term analgesia.
摘要：
背景：微创腹股沟疝修补术后的慢性疼痛会对生活质量（QOL）产生衰弱影响，限制日常活动和工作能力。已经提出了许多医疗和手术治疗方案，然而，对于网状物移植在这些患者的治疗中的作用尚无共识。
方法：我们对2012年7月至2023年7月在我们机构接受了通过机器人或腹腔镜方法去除腹股沟网状物的所有患者进行了回顾性审查。术后对患者进行访谈以确定其总体疼痛评分，并使用CarolinasComfortScale（CCS）问卷评估QOL。患者特征,手术时间，还记录了术前成像技术和镇痛使用情况.
结果：22例慢性疼痛患者行腹股沟网片摘除术，包括12个机器人和10个腹腔镜手术。所有患者术前平均疼痛评分为7.6/10，术后为4.0/10。术后CCS平均评分为24分，表明中度不适。四名患者表现出CCS评分<11,表明没有不适,并且没有患者表现出CCS评分>90,表明严重的衰弱不适。大多数患者术后镇痛摄入量减少或完全停止。
结论：腹腔镜和机器人网状移植治疗腹股沟疝修补术后慢性疼痛在减轻疼痛和减少长期镇痛方面都是安全有效的。
方法：我们对2012年7月至2023年7月在我们机构接受了通过机器人或腹腔镜方法去除腹股沟网状物的所有患者进行了回顾性审查。术后对患者进行访谈以确定其总体疼痛评分，并使用CarolinasComfortScale（CCS）问卷评估QOL。患者特征,手术时间，还记录了术前成像技术和镇痛使用情况.
结果：22例慢性疼痛患者行腹股沟网片摘除术，包括12个机器人和10个腹腔镜手术。所有患者术前平均疼痛评分为7.6/10，术后为4.0/10。术后CCS平均评分为24分，表明中度不适。四名患者表现出CCS评分<11,表明没有不适,并且没有患者表现出CCS评分>90,表明严重的衰弱不适。大多数患者术后镇痛摄入量减少或完全停止。
结论：腹腔镜和机器人网状移植治疗腹股沟疝修补术后慢性疼痛在减轻疼痛和减少长期镇痛方面都是安全有效的。
