[Pneumoperitoneum and Mersilene mesh in the treatment of giant abdominal wall hernias].

Fourteen patients with giant abdominal hernias were treated at our institution from 1985-1989. In all cases the hernial orifice was at least 20 x 20 cm, and the hernia had at least a size of a child's head. In 11 cases a progressive preoperative pneumoperitoneum of 10-14 liters over 14-21 days was performed. This procedure was initially done in hospital and then on an outpatient basis. In 13 patients the hernia was repaired using a retromuscular/preperitoneal Mersilen-mesh fixed subcutaneously. In one patient the hernia could be repaired with a Mayo type repair after preparation with a pneumoperitoneum. Postoperative problems were minimal, and no recurrence has so far been observed after a follow-up period of 5 to 44 months. By the combination of preoperative pneumoperitoneum and a retromuscular Mersilen-mesh even giant abdominal hernias in polymorbid patients can be repaired.