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Acta Médica Costarricense

On-line version ISSN 0001-6002Print version ISSN 0001-6012


MORA-SEGURA, Esteban; ORELLANA-SOTO, Pablo; VEGA-SANCHEZ, Olga  and  MOYA-SANCHO, Eduardo. The use of progressive preoperative pneumoperitoneum as treatment in giant abdominal wall hernia. Acta méd. costarric [online]. 2018, vol.60, n.1, pp.48-52. ISSN 0001-6002.

Surgery for the correction of giant ventral hernias, with loss of abdominal domain, represents a major challenge due to the large number of potential comorbidities. In this pathology there is a migration of the abdominal organs to the hernia sac; eventually, the elements of the wall undergo atrophy and when trying to return the organs to their normal position, it can cause multiple adverse effects in the patient. Therefore, a careful planning must be carried out preoperatively. The use of progressive preoperative pneumoperitoneum, allows a more adequate adaptation from the physiological point of view, both at a systemic level, as in the abdominal capacity, to tolerate the return of contents that have lost their domain. We present here the case of a 58 year old female patient, with a giant ventral hernia with loss of abdominal domain, in whose management, the introduction of progressive preoperative pneumoperitoneum was used, described for the first time by Goñi Moreno, in 1940.

Keywords : progressive pneumoperitoneum; giant hernia; loss of abdominal domain; abdominal wall; Goñi Moreno.

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