Preoperative pneumoperitoneum for treatment Giant inguinal hernia: Review of our experience

Objective: To assess the potential benefits of preoperative pneumoperitoneum in the management of giant inguinal hernias. Material and methods: Prospective study using follow-up of two cases of giant hernias inguinoscrotal requiring preoperative pneumoperitoneum in our center from October 2013 to March 2014. Results: During the last 5 months have been diagnosed two subsidiaries of giant hernias inguinoscrotal preoperative pneumoperitoneum in our center. These were 2 men with a mean age of 60.5 (55-66). None had clinically relevant and attended outpatients referred by other specialists. In one patient the hernia was bilateral and the other unilateral. As evidence of preoperative imaging in both cases computed tomography was performed. Patients admitted a week before surgery ( range 6-8 days) to perform preoperative pneumoperitoneum by Verres needle placement with daily blow ambient air (between 240-1 000 cc). It was performed as a repair technique in the 2 cases with preperitoneal hernioplasty posterior approach through a midline laparotomy. Highlight ileus as immediate complication (2-4 days). The mean postoperative hospital stay was 17.5 days (15-20 days). One month postoperative follow-up was performed with no evidence of complications, only underline the lack of reduction in size of the scrotum. Conclusions: Progressive preoperative pneumoperitoneum favors repairing giants hernias inguinoscrotal loss right at home. It is a safe and reproducible procedure with a low complication rate and high tolerability by the patient. (C) 2014 Sociedad Hispanoamericana de Hernia. Published by Elsevier Espana, S.L.U. All rights reserved.