الفهرس 
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Abstract
Lichtenstein tension free mesh hernioplasty is the gold standard and the method of choice for the repair of inguinal hernia in the developed countries. Ilioinguinal nerve trauma throughout dissection, inflammation or fibrosis and nerve entrapment by the mesh have all been involved in the pathogenesis of inguinodynia. The ilioinguinal nerve is a peripheral branch of the lumbar plexus. It goes through the lateral abdominal muscles, then into the inguinal canal, before innervating the supero medial part of the thigh, the teguments of the pubis, the scrotum in men, and the labia majora in women. The ilioinguinal nerve usually faced during open inguinal hernia repair and has been involved in the pathogenesis of post-operative chronic groin pain. Elective detachment of the ilioinguinal nerve has been recommended in an attempt to reduce the frequency of chronic groin pain following open mesh hernia repair. The importance of elective nerve detachment to decrease the postoperative pain was highlighted by some authors, considering the ilioinguinal neurectomy to be a part of regular surgical step. Good planning preoperatively for ilioinguinal nerve resection has been observed to decrease the incidence of postoperative pain. A major source of morbidity is reduced using this simple procedure. During the period from March 2020 to February 2021, a total of 100 adult male patients with 100 primary inguinal hernias underwent Lichtenstein tension free mesh hernioplasty in endocrine surgery unit, general surgery department, Mansoura University. They were randomly divided into two equal groups (A and B) each group included 50 pateints using toss method. Patients in group A were subjected to IIN resection during hernia repair while patients in group B were subjected to nerve preservation. Regarding the age of patients in both groups; the mean age of patients in group A was 42.55±3.573 while it was 41.9±2.99 in group B. There was no statistical significant difference between both groups (p= 0.652). As regard the precipitating factors (smoking, BPH, Splenomegally, Bronchial asthma) and type of work. The difference between the two groups wasn’t statistically significant for both precipitating factors and type of work. (p>0.05) The most common early postoperative complication in group A was mild scrotal edema while in group B, seroma and wound infection were more common. There was neither hematoma nor recurrence in both groups. The difference between both groups was insignificant. Follow-up of postoperative groin pain was done at1st and 7th POD and after 1, 3 and 6 months during rest as well as after minor exercises using NRS. Follow-up of postoperative sensory changes (numbness and hypoesthesia) at the groin was done at same follow-up periods during rest only using VRS. Incidence of postoperative groin pain was significantly lower in neurectomy group (A) than preservation group (B) in all follow-up periods. The difference between both groups regarding severity of postoperative inguinal pain after minor exercises was found to be statistically higher in group B than in group A especially at follow-up at 1, 3 and 6 months (p=0.013, 0.033, 0.018) respectively. The range of duration during which patients required analgesia in group A was 2-6 days with a mean 3.45 ± 0.3118 and was 5-14 days with a mean 9.8± 0.67121in group B. The difference between both groups regarding type and duration of analgesia were statistically significant higher for patients in group B than in patients of group A (p˂0.05). Incidence of moderate / severe pain at 3 & 6 months postoperative was significantly lower in patients who underwent resection of IIN (group A) than IIN preservation group (B). Conclusion: from our study it is shown that resection of ilioinguinal nerve during inguinal hernia repair reduces significantly the incidence of post-operative chronic inguinal pain, so it is advisable to sacrifice the ilioinguinal nerve during inguinal hernia repair.