Moseholm Viktor Bay, Baker Jason Joe, Rosenberg Jacob
Center for Perioperative Optimization, Department of Surgery, Copenhagen University Hospital - Herlev and Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.
Hernia. 2025 May 30;29(1):191. doi: 10.1007/s10029-025-03388-7.
AIM/BACKGROUND: Nerve management during open inguinal hernia repair is thought to influence the incidence of postoperative chronic pain. Understanding nerve anatomy may assist surgeons in identifying and protecting nerves during surgery. In this study, we aimed to describe the anatomical variations and locations of the ilioinguinal, iliohypogastric, and genitofemoral nerves as reported in cadaver studies.
We conducted a search in Pubmed, Embase, CNKI, and LILACS. Studies reporting on adult cadavers with detailed descriptions of the ilioinguinal, iliohypogastric, or genitofemoral nerves were included. Studies on cadavers that were previously operated on for inguinal hernia or anatomical areas not relevant to inguinal hernia surgery were excluded.
Out of 2,196 records, 115 articles were screened, and 47 articles met the inclusion criteria. The ilioinguinal nerve was typically found in the Lichtenstein operative field, running ventrally along the spermatic cord, parallel to the inguinal ligament. The iliohypogastric nerve was usually located cranial to the ilioinguinal nerve and spermatic cord, positioned between the internal and external oblique abdominal muscles. The genitofemoral nerve was generally found beneath the spermatic cord alongside the accompanying vessels. While the iliohypogastric nerve displayed the most consistent anatomical position, all nerves showed significant variations, with frequent occurrences of nerve fusion.
The three major nerves involved in an open inguinal hernia repair exhibit considerable anatomic variability. Surgeons need to be cognizant of these variations to prevent nerve damage.
目的/背景：开放腹股沟疝修补术中的神经管理被认为会影响术后慢性疼痛的发生率。了解神经解剖结构可能有助于外科医生在手术中识别和保护神经。在本研究中，我们旨在描述尸体研究中报道的髂腹股沟神经、髂腹下神经和生殖股神经的解剖变异和位置。
我们在PubMed、Embase、中国知网和拉丁美洲及加勒比地区卫生科学数据库进行了检索。纳入了对成年尸体进行研究且对髂腹股沟神经、髂腹下神经或生殖股神经有详细描述的研究。排除了对曾接受腹股沟疝手术的尸体或与腹股沟疝手术无关的解剖区域的研究。
在2196条记录中，筛选出115篇文章，47篇文章符合纳入标准。髂腹股沟神经通常出现在Lichtenstein手术视野中，沿精索腹侧走行，与腹股沟韧带平行。髂腹下神经通常位于髂腹股沟神经和精索的上方，位于腹内斜肌和腹外斜肌之间。生殖股神经通常在精索下方与伴行血管一起被发现。虽然髂腹下神经显示出最一致的解剖位置，但所有神经都表现出显著变异，神经融合频繁发生。
开放腹股沟疝修补术中涉及的三条主要神经表现出相当大的解剖变异性。外科医生需要认识到这些变异以防止神经损伤。
