Update on the use of preoperative pneumoperitoneum prior to the repair of large hernias of the abdominal wall.

A review of eight repairs of large hernias of the abdomen pretreated with progressive artificial pneumoperitoneum is presented. Although three recurrences were noted during the follow-up period, two of the recurrences were repaired easily without further herniation. The advantages and complications of this procedure are discussed. Although the use of pneumoperitoneum prior to herniorrhaphy has been well described in the past, current emphasis on prosthetic mesh repairs has overshadowed its advantages. Progressive preoperative pneumoperitoneum as an adjunct to the repair of large abdominal hernias and eventrations should be part of the armamentarium of surgeons who are confronted with these difficult operative problems.