Progressive preoperative pneumoperitoneum (PPP) as an adjunct for surgery of hernias with loss of domain

Chirurgia (Bucur). 2014 Sep-Oct;109(5):664-9.

Abstract

Background: forced repair of a giant abdominal wall defect end with unsatisfactory results despite development of prosthetics materials. The enlargement of abdominal wall dimensions could be realized altogether other methods with the aid of pneumo-peritoneum. The aim of the study is to evaluate early results of the method used for patients with giant incisional hernias.

Material and methods: between june 1998 - june 2013, 17 patients (4 males) with giant abdominal wall defects (incisional and inguinal hernias) were prepaired for radical surgery with pneumoperitoneum. Average age was 64.35 years. We reevaluated the standard constants of the pulmonary function,blood gases, and intra-vesical pressure in 3 moments: before the first gas insuflation, 24 hours before surgery and in the 7th daypost operatively.

Results: the method was free of accidents or incidents, no mortality was recorded. The respiratory function was significantly increased and also the intra-abdominal pressure.

Conclusion: our results suggest that the method of progressive pneumoperitoneum is safe, costless of choice for creating a clear compatibility between the wall and abdominal content inpatients with giant abdominal wall defects. Also ensures a longterm and stable improvement of the respiratory function in all its components.

MeSH terms

  • Aged
  • Female
  • Hernia, Inguinal / surgery*
  • Hernia, Ventral / surgery*
  • Humans
  • Male
  • Middle Aged
  • Pneumoperitoneum, Artificial*
  • Preoperative Care* / methods
  • Recurrence
  • Respiratory Function Tests / methods
  • Retrospective Studies
  • Treatment Outcome