Medico-legal case series of litigation involving chronic post-herniorrhaphy inguinal pain: insights from Italian civil verdicts.

IF 2.4 2区医学 Q1 SURGERY

Hernia Pub Date : 2025-10-08 DOI:10.1007/s10029-025-03472-y

Roberto Cirocchi, Luca Tomassini, Salvatore Guarino, Andrea Mingoli, Diletta Cassini, Bruno Cirillo, Massimo Lancia, Piergiorgio Fedeli, Paolo Bruzzone

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引用次数: 0

Abstract

Purpose: Chronic postherniorrhaphy inguinal pain (CPIP) is a recognized postoperative complication and a potential trigger for malpractice litigation. This case series presents a descriptive medicolegal analysis of civil verdicts involving CPIP following inguinal hernia repair in Italy.

Methods: A retrospective review was performed using the Italian Ministry of Justice's Banca Dati di Merito, examining malpractice verdicts from 2015 to 2025 related to CPIP after hernioplasty. Seventeen cases met the inclusion criteria. Variables collected included type of nerve injury, surgical technique, fixation method, informed consent, reinterventions, and symptom profile. Data were summarized using descriptive statistics.

Results: Compensation was awarded in 4 of 17 cases (23.5%). Nerve injury was documented in 13 cases (76.5%), with genitofemoral nerve involvement in 6 of these (46.2%). Among the six cases with genitofemoral injury, four received compensation (66.7%), while no compensation occurred in cases without such injury. Neurectomy was performed in 5 cases, three of which resulted in compensation (60.0%) compared with 1 of the 12 cases without neurectomy (8.3%). Informed consent forms were available in 5 cases; in three of these, the risk of nerve injury was omitted, with one case leading to compensation.

Conclusion: This descriptive case series highlights a potential association between genitofemoral nerve injury and compensation outcomes in CPIP-related litigation. In most cases involving genitofemoral injury, compensation was awarded. Neurectomy also appeared to show a trend toward legal relevance. These findings reinforce the medico-legal importance of accurate nerve identification, thorough intraoperative documentation, and attentive postoperative management in hernia surgery. Further prospective studies are warranted to confirm these preliminary observations and inform both surgical and legal best practices.

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涉及慢性疝修补术后腹股沟疼痛的医学法律案件系列诉讼：来自意大利民事判决的见解。

目的：慢性缝合后腹股沟疼痛（CPIP）是公认的术后并发症和潜在的触发医疗事故诉讼。这个系列的案例提出了一个描述性的医学法律分析民事判决涉及CPIP后腹股沟疝修补在意大利。方法：使用意大利司法部的Banca Dati di Merito进行回顾性审查，审查2015年至2025年与疝成形术后CPIP相关的医疗事故判决。17例符合纳入标准。收集的变量包括神经损伤类型、手术技术、固定方法、知情同意、再干预和症状特征。数据采用描述性统计进行汇总。结果：17例患者中有4例获得赔偿，占23.5%。神经损伤13例（76.5%），其中6例（46.2%）累及生殖股神经。6例生殖股骨头损伤患者中，有4例（66.7%）获得了赔偿，无生殖股骨头损伤患者无赔偿。5例行神经切除术，其中3例获得补偿（60.0%），12例未行神经切除术1例（8.3%）。在5个病例中提供了知情同意书；在其中的三个案例中，神经损伤的风险被忽略，其中一个案例导致赔偿。结论：这个描述性的病例系列强调了生殖器股神经损伤与cpip相关诉讼的赔偿结果之间的潜在关联。在大多数涉及生殖器损伤的案件中，都给予赔偿。神经切除术似乎也显示出法律相关性的趋势。这些发现强化了在疝手术中准确的神经识别、完整的术中记录和细心的术后管理的医学-法律重要性。进一步的前瞻性研究有必要证实这些初步观察结果，并为外科和法律的最佳实践提供信息。

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来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.