“Groin disruption” in athletes is caused by a pattern of injuries known as “Gilmore's Groin”, “Chronic groin pain’”, “Sportsmans Hernia”, “Athletic pubalgia”, “Slap shot gut syndrome”, “Sports hernia” etc.
It’s description includes a lack of visible external signs in the affected groin, dilatation of the superficial inguinal ring (felt by inversion of the scrotum with the little finger tip), a cough impulse, and marked tenderness on the affected side. Groin disruption is a complex musculoskeletal disruption, not a true hernia.
If a Groin disruption is diagnosed and other disorders are excluded, the condition can be surgically repaired. For groin disruption open (mesh repair, sutured repair, neurolysis or neurectomy, etc) or laparoscopic surgery techniques (TAPP or TEP, etc) can be used. What operation is the optimal and most physiological for surgery of “groin disruption” in professional athletes? Which operation do you prefer? Open or laparoscopic? Mesh or sutures? Neurolysis or neurectomy? Commerce or medicine?
Pain killers, wait for three months,reevaluate clinically and with ultrasound , if hernia is demonstrated suture repair.
I think it is a matter of surgical expertise, age of the patient and symptoms of the patient. My hospital was one of the earliest centers in Germany treating these patients during the 1980-ties. The treatment consisted of conventional open surgical exploration of the groin with reconstruction with a modification of Bassini's repair. In some patients the insertion of the M. adductor magnus or M. rectus abdominis was incised as it was/is done in tennis elbow (Homann's repair). Later on with the development of laparoscopic techniques these methods (TAPP or TEP) were in favour acoording to an open dicussion durging the congress of the German Hernia Society. However a period of about 3 months - as mentioned by pradeep Basappa - should be prior to the decision of operation. Many patients feel relief, but as after groin hernia surgery some patients develop severe grion pain syndrome.
My opinion is that open repair could b better because (triple) neurectomy can be added to the hernioplasty procedure.
Recent data including Paajanen's paper implies that a laparoscopic repair (TEP) is the best solution for a disrupted groin or sportmen's hernia.
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