Abstract
'On-table' pneumoperitoneum before repair of 'complicated' incisional hernias has been used in eight patients considered to be at high risk of recurrence. In four patients the procedure revealed the presence of occult defects. The procedure was uncomplicated and a primary repair without the need for a prosthetic implant was possible in all cases. Six patients remain well with no sign of recurrence at a median follow-up of 96 months (range 22-120 months). Two patients died from conditions unrelated to the method of repair; acute necrotising pancreatitis on the 10th postoperative day and lobar pneumonia 2 months postoperatively. Peroperative pneumoperitoneum is a simple procedure which obviates the need for a prosthetic implant in selected patients. It is therefore particularly useful in the management of incisional hernias associated with sepsis, stomas or in patients requiring synchronous bowel resection.
Full text
PDF


Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Astudillo R., Merrell R., Sanchez J., Olmedo S. Ventral herniorrhaphy aided by pneumoperitoneum. Arch Surg. 1986 Aug;121(8):935–936. doi: 10.1001/archsurg.1986.01400080081014. [DOI] [PubMed] [Google Scholar]
- Barst H. H. Pneumoperitoneum as an aid in the surgical treatment of giant herniae. Br J Surg. 1972 May;59(5):360–364. doi: 10.1002/bjs.1800590507. [DOI] [PubMed] [Google Scholar]
- Cady B., Brooke-Cowden G. L. Repair of massive abdominal wall defects. Combined use of pneumoperitoneum and Marlex mesh. Surg Clin North Am. 1976 Jun;56(3):559–570. doi: 10.1016/s0039-6109(16)40931-x. [DOI] [PubMed] [Google Scholar]
- Caldironi M. W., Romano M., Bozza F., Pluchinotta A. M., Pelizzo M. R., Toniato A., Ranzato R. Progressive pneumoperitoneum in the management of giant incisional hernias: a study of 41 patients. Br J Surg. 1990 Mar;77(3):306–307. doi: 10.1002/bjs.1800770322. [DOI] [PubMed] [Google Scholar]
- Connolly D. P., Perri F. R. Giant hernias managed by pneumoperitoneum. JAMA. 1969 Jul 7;209(1):71–74. [PubMed] [Google Scholar]
- Deitel M., Vasic V. A secure method of repair of large ventral hernias with Marlex mesh to eliminate tension. Am J Surg. 1979 Feb;137(2):276–277. doi: 10.1016/0002-9610(79)90164-8. [DOI] [PubMed] [Google Scholar]
- Johnson W. C. Pneumoperitoneum for ventral hernia repair: anesthesia complication. JAMA. 1971 Aug 16;217(7):968–968. [PubMed] [Google Scholar]
- Johnson W. C. Preoperative progressive pneumoperitoneum in preparation for repair of large hernias of the abdominal wall. Am J Surg. 1972 Jul;124(1):63–68. doi: 10.1016/0002-9610(72)90169-9. [DOI] [PubMed] [Google Scholar]
- KOONTZ A. R., GRAVES J. W. Preoperative pneumoperitoneum as an aid in the handling of gigantic hernias. Ann Surg. 1954 Nov;140(5):759–762. doi: 10.1097/00000658-195411000-00018. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Larson G. M., Harrower H. W. Plastic mesh repair of incisional hernias. Am J Surg. 1978 Apr;135(4):559–563. doi: 10.1016/0002-9610(78)90037-5. [DOI] [PubMed] [Google Scholar]
- MANSUY M. M., HAGER H. G., Jr Pneumoperitoneum in preparation for correction of giant hernias. N Engl J Med. 1958 Jan 2;258(1):33–34. doi: 10.1056/NEJM195801022580107. [DOI] [PubMed] [Google Scholar]
- MASON E. E. Pneumoperitoneum in the management of giant hernia. Surgery. 1956 Jan;39(1):143–151. [PubMed] [Google Scholar]
- Raynor R. W., Del Guercio L. R. Update on the use of preoperative pneumoperitoneum prior to the repair of large hernias of the abdominal wall. Surg Gynecol Obstet. 1985 Oct;161(4):367–371. [PubMed] [Google Scholar]
- Smith R. S. The use of prosthetic materials in the repair of hernias. Surg Clin North Am. 1971 Dec;51(6):1387–1399. doi: 10.1016/s0039-6109(16)39595-0. [DOI] [PubMed] [Google Scholar]
- Steichen F. M. A simple method for establishing, maintaining, and regulating surgically induced pneumoperitoneum in preparation for large hernia repairs. Surgery. 1965 Dec;58(6):1031–1032. [PubMed] [Google Scholar]
- TOUROFF A. S. Phrenicetomy as aid to repair of large abdominal hernias. J Am Med Assoc. 1954 Jan 23;154(4):330–332. doi: 10.1001/jama.1954.02940380040010b. [DOI] [PubMed] [Google Scholar]
- ZIFFREN S. E., WOMACK N. A. An operative approach to the treatment of gigantic hernias. Surg Gynecol Obstet. 1950 Dec;91(6):709–710. [PubMed] [Google Scholar]

