Skip to main content
Log in

Progressive pneumoperitoneum increases the length of abdominal muscles

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript

Abstract

The aim of this prospective observational study was to determine the effects of progressive preoperative pneumoperitoneum (PPP) on the size of large incisional hernia (IH) and abdominal muscles by abdominal computed tomography (CT) scan. PPP was performed in 18 patients. All IH were large. A mean volume of 12.8 l was insufflated over a mean period of 14.8 days. Respectively, before and after PPP, the mean IH height and width was 117 and 130 mm (P < 0.05) and 101 and 115 mm (P < 0.05), the mean width of the right and left rectus abdominis was 99 and 109 mm (P < 0.05) and 100 and 113 mm (P < 0.05), and the length of the right and left anterolateral muscles was 198 and 233 mm (P < 0.05) and 185 and 210 mm (P < 0.01). In conclusion, PPP increases the abdominal wall muscle length and has the same impact on the IH orifice. PPP would facilitate the fascial repair of otherwise untreatable large IH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Moreno IG (1940) Eventracion cronica gigante preparada con neumoperitoneo y operada. Informe preliminar. Buenos Aires: XXII Congreso Arhentino Cirurgia

  2. Buddee FW, Coupland GA, Reeve TS (1975) Large abdominal wall herniae: an easy method of repair without prosthetic material, with the induction of pneumoperitoneum. Aust N Z J Surg 45:265–270

    Article  PubMed  CAS  Google Scholar 

  3. Raynor RW, Del Guercio LR (1989) The place for pneumoperitoneum in the repair of massive hernia. World J Surg 13:581–585

    Article  PubMed  CAS  Google Scholar 

  4. Toniato A, Pagetta C, Bernante P, Piotto A, Pelizzo MR (2002) Incisional hernia treatment with progressive pneumoperitoneum and retromuscular prosthetic hernioplasty. Langenbecks Arch Surg 387:246–248

    Article  PubMed  Google Scholar 

  5. Koontz AR, Graves JW (1954) Preoperative pneumoperitoneum as an aid in the handling of gigantic hernias. Ann Surg 140:759–762

    Article  PubMed  CAS  Google Scholar 

  6. Handelsman JC (1959) A technique for increasing abdominal capacity in the repair of massive ventral hernia. Surg Gynecol Obstet 108:751–755

    PubMed  CAS  Google Scholar 

  7. Caldironi MW, Romano M, Bozza F, Pluchinotta AM, Pelizzo MR, Toniato A et al (1990) Progressive pneumoperitoneum in the management of giant incisional hernias: a study of 41 patients. Br J Surg 77:306–307

    Article  PubMed  CAS  Google Scholar 

  8. Galeano F, Azulay D, Montoreano F (1965) Progressive pneumoperitoneum in the diagnosis and treatment of hernias and eventrations. J Chir (Paris) 89:95–97

    CAS  Google Scholar 

  9. Swelstad J, Caprini JA (1978) Use of progressive pneumoperitoneum in the treatment of giant abdominal hernias. Am Surg 44:337–341

    PubMed  CAS  Google Scholar 

  10. Forrest J (1979) Repair of massive inguinal hernia: with pneumoperitoneum and without using prosthetic mesh. Arch Surg 114:1087–1088

    PubMed  CAS  Google Scholar 

  11. Stoppa R, Ralaimiaramanana F, Henry X, Verhaeghe P (1999) Evolution of large ventral incisional hernia repair. The French contribution to a difficult problem. Hernia 3:1–3

    Article  Google Scholar 

  12. Berlemont M (1952) Pneumoperitoneum as a cure for enormous irreducible hernias. Mem Acad Chir (Paris) 78:77–78

    CAS  Google Scholar 

  13. Trivellini G, Zanella G, Danelli PG, Pratolongo D, Ferri O (1984) Surgical treatment of large eventrations. Study of a technic adapted to disorders of respiratory compliance. Chirurgie 110:116–122

    PubMed  CAS  Google Scholar 

  14. La Meir M, Vierendeels T, Poortmans M (2002) Pneumoperitoneum in repair of giant hernias and eventrations. Acta Chir Belg 102:263–265

    PubMed  Google Scholar 

  15. Cady B, Brooke-Cowden GL (1976) Repair of massive abdominal wall defects. Combined use of pneumoperitoneum and Marlex mesh. Surg Clin North Am 56:559–570

    PubMed  CAS  Google Scholar 

  16. Moreno IG (1978) The rational treatment of hernias and voluminous chronic eventrations: preparation with progressive pneumoperitoneum. In: Nyhus LM, Condon RE (eds) Hernia, 2nd edn. Lippincott, Philadelphia, pp 536–550

    Google Scholar 

  17. Johnson WC (1972) Preoperative progressive pneumoperitoneum in preparation for repair of large hernias of the abdominal wall. Am J Surg 124:63–68

    Article  PubMed  CAS  Google Scholar 

  18. Mousseau M, Barbin J, Labatard-Sartre R (1959) Importance of emergency penumoperitoneum in the treatment of certain strangulated eventrations. Mem Acad Chir (Paris) 85:795–798

    CAS  Google Scholar 

  19. Coelho JC, Brenner AS, Freitas AT, Campos AC, Wiederkehr JC (1993) Progressive preoperative pneumoperitoneum in the repair of large abdominal hernias. Eur J Surg 159:339–341

    PubMed  CAS  Google Scholar 

  20. Rouviere H (1967) Human anatomy, 10th edn. Masson, Paris

    Google Scholar 

  21. Korenkov M, Paul A, Sauerland S, Neugebauer E, Arndt M, Chevrel JP et al (2001) Classification and surgical treatment of incisional hernia. Results of an experts’ meeting. Langenbecks Arch Surg 386:65–73

    Article  PubMed  CAS  Google Scholar 

  22. Galeano F, Azulay D, Montoreano F Jr (1962) Progressive pneumoperitoneum in the diagnosis and treatment of hernias and eventrations. Prensa Med Argent 49:1584–1585

    PubMed  CAS  Google Scholar 

  23. Raynor RW, Del Guercio LR (1985) Update on the use of preoperative pneumoperitoneum prior to the repair of large hernias of the abdominal wall. Surg Gynecol Obstet 161:367–371

    PubMed  CAS  Google Scholar 

  24. Stoppa R, Louis D, Henry X, Verhaeghe P (1985) Postoperative eventrations. Apropos of a series of 247 surgically treated patients. Chirurgie 111:303–305

    PubMed  CAS  Google Scholar 

  25. Astudillo R, Merrell R, Sanchez J, Olmedo S (1986) Ventral herniorrhaphy aided by pneumoperitoneum. Arch Surg 121:935–936

    PubMed  CAS  Google Scholar 

  26. Rives J, Pires JC, Flament JB, Palot JP, Burde A, Avisse C (1987) Major incisional hernia. In: Chevrel JP (ed) Surgery of the abdominal wall. Springer, Berlin, pp 116–144

    Google Scholar 

  27. Coutinho EL, Gomes AR, França CN, Oishi J, Salvini TF (2004) Effect of passive stretching on the immobilized soleus muscle fiber morphology. Braz J Med Biol Res 37:1853–1861

    Article  PubMed  CAS  Google Scholar 

  28. Leguerrier A (1991) New file of anatomy P.C.E.M.––abdomen. Heures de France, Paris

    Google Scholar 

  29. Mason EE, Dayton MT (1995) Pneumoperitoneum in giant hernia. In: Nyhus LM, Condon RE (eds) Hernia, 4th edn. Lippincott, Philadelphia, pp 515–524

    Google Scholar 

  30. Chevrel JP, Rath AM (2000) Classification of incisional hernias of the abdominal wall. Hernia 4:7–11

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. M. Regimbeau.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dumont, F., Fuks, D., Verhaeghe, P. et al. Progressive pneumoperitoneum increases the length of abdominal muscles. Hernia 13, 183–187 (2009). https://doi.org/10.1007/s10029-008-0436-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10029-008-0436-3

Keywords

Navigation