title: Incisional hernia treatment with progressive pneumoperitoneum and retromuscular prosthetic hernioplasty.
abstract: OBJECTIVE
  Major incisional hernias of the abdominal wall often pose a serious surgical problem. The choice between simple suture repair and mesh repair remains uncertain.
  
  
  METHODS
  Seventy-seven patients underwent surgery to repair large abdominal incisional hernias, i.e., with parietal defects of 10 cm or more, by retromuscular prosthetic hernioplasty between 1996 and 1999. All patients were treated preoperatively by progressive pneumoperitoneum and were followed up for 2-5 years (mean 38.3 months).
  
  
  RESULTS
  Almost all patients tolerated the pneumoperitoneum; no postoperative death occurred. Six patients developed a subcutaneous infection but none of them required removal of the mesh. Two patients (2.6%) had recurrent incisional hernia.
  
  
  CONCLUSIONS
  This study shows that pneumoperitoneum is useful in preparing patients for incisional hernioplasty. Retromuscular mesh repair represents an appropriate surgical procedure, particularly in view of its low rate of recurrence.
authors.affiliation: Department of Medical and Surgical Sciences, 3rd Clinic of General Surgery, University of Padua, Via Giustiniani 2, 35128 Padua, Italy. mariarosa.pelizzo@unipd.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Toniato
authors.forename: Costantino
authors.initials: C
authors.lastname: Pagetta
authors.forename: Paolo
authors.initials: P
authors.lastname: Bernante
authors.forename: Andrea
authors.initials: A
authors.lastname: Piotto
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Pelizzo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D012008:Recurrence; D013526:Surgical Mesh