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

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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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