title: [Progressive preoperative pneumoperitoneum in patients with giant hernias of the abdominal wall].
abstract: BACKGROUND
  Patients with giant hernias with loss of domain require proper planning of surgical repair, because of the high associated comorbidity. The progressive preoperative pneumoperitoneum technique described by Goñi Moreno allows a more physiological adaptation of the patient and the abdominal cavity to the reinstatement of the viscera to the abdomen, enabling adequate surgical repair. The objective of this study was to analyze our experience in the treatment of this type of hernia.
  
  
  METHODS
  We carried out a retrospective study that included 11 patients with major abdominal wall defects and loss of domain who were treated with this technique in 2 centers between 2005 and 2010.
  
  
  RESULTS
  Eight patients had abdominal hernias and 3 had inguinal hernias. The average insufflation time was 2 weeks and the total amount of air was between 6.6 and 18 l. In 2 patients who showed pulmonary disease decompensation, insufflation had to be temporarily postponed. A further 2 patients had subcutaneous emphysema during the last few days of insufflation, which resolved spontaneously without sequelae. The open mesh repair technique was used in ventral hernias and the preperitoneal technique in all inguinal hernias. There was one recurrence during the 1-year follow-up.
  
  
  CONCLUSIONS
  Goñi Moreno's technique remains safe to prepare patients with giant hernias with loss of domain. This procedure can reduce the morbidity caused by the increase in abdominal pressure after abdominal wall repair.
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital General de L'Hospitalet Consorci Sanitari Integral, Hospitalet del Llobregat, Barcelona, España. maclaire@yahoo.com
authors.forename: María Clara
authors.initials: MC
authors.lastname: López Sanclemente
authors.forename: Joaquim
authors.initials: J
authors.lastname: Robres
authors.forename: Manuel
authors.initials: M
authors.lastname: López Cano
authors.forename: Joan
authors.initials: J
authors.lastname: Barri
authors.forename: Roberto
authors.initials: R
authors.lastname: Lozoya
authors.forename: Sergio
authors.initials: S
authors.lastname: López
authors.forename: M Angeles
authors.initials: MA
authors.lastname: Vasco
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Buqueras
authors.forename: Helena
authors.initials: H
authors.lastname: Subirana
authors.forename: Rosa
authors.initials: R
authors.lastname: Jorba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006552:Hernia, Inguinal / Q000473:pathology* / Q000601:surgery*; D006555:Hernia, Ventral / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial / Q000379:methods*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies
keywords: Eventración; Eventration; Goñi Moreno; Loss of domain; Neumoperitoneo; Pneumoperitoneum; Pérdida de domicilio