Neumoperitoneo en el tratamiento de hernias gigantes.

El uso del neumoperitoneo preoperatorio progresi-
vo ha demostrado ser una técnica útil y eficaz para el
tratamiento de grandes defectos de la pared abdominal.
Está indicado en hernias gigantes, pacientes de
alto riesgo quirúrgico y grandes defectos recidivados.
Se describe a 4 pacientes en los que se empleó
neumoperitoneo progresivo realizado bajo anestesia
local y sedación entre 1 y 3 semanas antes de la cirugía,
seguido del tratamiento del defecto herniario con
malla preperitoneal. Dos pacientes en régimen ambulatorio
y 2 hospitalizados.
No se detectaron complicaciones
postoperatorias.
Durante el seguimiento (10
meses-11 años) no hubo evidencias de recidiva.

eum has been demonstrated to be safe and effective
in the treatment of large hernias. The indications for this
technique include massive hernias, hernias in patients
with high surgical risk, and large recurrent hernias.
We describe four patients in whom progressive
pneumoperitoneum was carried out under local
anesthesia and sedation between 1 and 3 weeks before
surgery.
All four hernias were closed with a preperitoneal
mesh.
Insufflation was performed on an inpatient
basis in two
patients and in the ambulatory
setting
in one.
No postoperative complications were
detected. No evidence of recurrence was found during
follow-up
(10 months-11 years).