>Year 2005, Issue 4
Mayagoitia GJC , Arenas RJC , Suárez FD , Díaz LV , Álvarez QR
Pre-operative progressive pneumoperitoneum in hernias of the abdominal wall with loss of domain
Cir Gen 2005; 27 (4)
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Objective:To present the modified technique of pre-operative, progressive pneumoperitoneum, as a choice method to prepare patients with giant hernias.
Setting:High Specialty Medical Unit, IMSS. City of León, Guanajuato.
Statistical analysis:Central tendency measures and dispersion in numerical variables. Frequency tables for descriptive variables.
Patients and methods:Prospective, descriptive study, from June 2003 to July 2005. A pre-operative, progressive pneumoperitoneum was induced by placing an abdominal, double lumen, catheter through a Veress needle and daily insufflation of 1 to 2 L of environmental air. Analyzed variables were: age, gender, body mass index (BMI), type, localization, size of the hernia defect, number of previous repairs, days of pneumoperitoneum, used hernia repair technique, and complications.
Results:In a 25-months period, 13 patients were recruited, 2 were excluded for being unable to perform the pneumoperitoneum. From the remainder 11 patients, 63.6% were women and 36.4% men, average age of 50.5 years, BMI of 35.4, time of evolution of the hernia, 8 months to 23 years. Ten patients coursed with ventral hernia and one with an inguinal hernia. Average duration of the pneumoperitoneum was of 9.8 days. We found no severe complications related to the puncture and duration of the pneumoperitoneum. There was only one case of dissection of the flap from a previous mastectomy. Hernia repair could be performed in all patients, nine with Rives’ technique, one with supra-aponeurotic mesh, and Liechtenstein’s technique was used for the inguinal hernia. There was only one infection of the surgical wound as post-operative complication.
Conclusions:The preoperative, progressive, pneumoperitoneum technique is a safe procedure, easy to apply, indicated in patients with giant hernia. It presents a low rate of complication and is adequately tolerated by patients and facilitates the surgical repair of the hernia. The modification proposed for the puncture technique makes the procedure safer.
||Incisional hernia, hernioplasty, pneumoperitoneum, complications.
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>Year 2005, Issue 4