OBJECTIVE: To present our experience of progressive preoperative pneumoperitoneum in the preparation of patients for repair of large hernias of the abdominal wall. DESIGN: Prospective selected series. SETTING: A university hospital and a district hospital. SUBJECTS: 36 Patients of the 252 who presented for abdominal hernia repair between January 1977 and April 1992. INTERVENTIONS: Air was insufflated into the peritoneal cavity through a 19 gauge spinal needle, and between 500 and 2000 ml was usually injected at the first session. Amounts were gradually increased daily or every other day for a period of 6-15 days; the total amount insufflated ranged from 4500-18,500 (mean 7700) ml. MAIN OUTCOME MEASURES: Whether the hernia could be repaired directly without recourse to polypropylene mesh, complications of pneumoperitoneum, and recurrence rate. RESULTS: In one patient air was insufflated into the colon, one developed temporary but severe respiratory distress, and 4 developed moderate subcutaneous emphysema. 30 hernias were repaired directly, and 6 required polypropylene mesh. There were three wound infections (two after direct repair), and two recurrences (both after direct repair). Mean length of follow up was 10 months (range 1-48). CONCLUSION: Progressive preoperative pneumoperitoneum allows direct repair of some large abdominal hernias with a low recurrence rate, and few complications.
OBJECTIVE: To present our experience of progressive preoperative pneumoperitoneum in the preparation of patients for repair of large hernias of the abdominal wall. DESIGN: Prospective selected series. SETTING: A university hospital and a district hospital. SUBJECTS: 36 Patients of the 252 who presented for abdominal hernia repair between January 1977 and April 1992. INTERVENTIONS: Air was insufflated into the peritoneal cavity through a 19 gauge spinal needle, and between 500 and 2000 ml was usually injected at the first session. Amounts were gradually increased daily or every other day for a period of 6-15 days; the total amount insufflated ranged from 4500-18,500 (mean 7700) ml. MAIN OUTCOME MEASURES: Whether the hernia could be repaired directly without recourse to polypropylene mesh, complications of pneumoperitoneum, and recurrence rate. RESULTS: In one patient air was insufflated into the colon, one developed temporary but severe respiratory distress, and 4 developed moderate subcutaneous emphysema. 30 hernias were repaired directly, and 6 required polypropylene mesh. There were three wound infections (two after direct repair), and two recurrences (both after direct repair). Mean length of follow up was 10 months (range 1-48). CONCLUSION: Progressive preoperative pneumoperitoneum allows direct repair of some large abdominal hernias with a low recurrence rate, and few complications.
Authors: J Bueno-Lledó; A Torregrosa; N Ballester; O Carreño; F Carbonell; P G Pastor; J Pamies; V Cortés; S Bonafé; J Iserte Journal: Hernia Date: 2017-01-25 Impact factor: 4.739
Authors: Kristen E Elstner; John W Read; Omar Rodriguez-Acevedo; Kevin Ho-Shon; John Magnussen; Nabeel Ibrahim Journal: Surg Endosc Date: 2016-08-29 Impact factor: 4.584