Ventral Herniorrhaphy Aided by Pneumoperitoneum

Twenty-four patients with large abdominal incisional hernias were alternately treated with preoperative pneumoperitoneum. The insufflation was performed on an outpatient basis each day for approximately one week prior to operation. The pneumoperitoneum-treated group was spared the necessity of developing abdominal wall flaps and presented a much easier peritoneal dissection. The operative time was 50 minutes in the 12 pneumoperitoneum-treated patients compared with an average of 150 minutes in the standard repair-treated group. There were no infections in the pneumoperitoneum-treated group compared with five (42%) in the other group. The postoperative stay of the pneumoperitoneum-treated group averaged 3.5 days compared with 12.5 days for the standard repair-treated group. Pneumoperitoneum is a valuable adjunct in the repair of large ventral hernias.