Preoperative pneumoperitoneum in the surgical preparation of complex eventrations

Abstract

Introduction: Complex eventration produce great defects on the abdominal wall whose repair means a great challenge. A correct planning with patients is needed in order to tackle this defect with success. Progressive preoperative pneumoperitoneum as a therapeutic tool to prepare these patients has improved the results of this surgery and reduced complications. Objective: The aim of this study is to demonstrate the efficacy of the pre-surgery preparation with pneumoperitoneum (PPP) as a complement to surgical reparation of the complex eventrations. Material and methods: Retrospective study of 24 patients with complex eventration, within April 2018 and January 2020, previously chosen to pre-surgery infiltration of pneumoperitoneum and that afterwards had the corresponding technique of surgical reparation applied. Results: Of all the studied cases, derived complications of using the PPP were almost inexistent and it was well tolerated by patients. The preparation with this technique took place throughout approximately 12 days before surgery and the amount of air provided was about 7,979 cm3. With that, the rise of the intraabdominal pressure after surgery is minimum, keeping it in optimal levels and decreasing possible complications. The correct application of this tool, the employed surgical techniques (TAR or Rives-Stoppa) and the use of prosthetic material have facilitated the success of the eventration’s repair. Conclusions: The PPP has turned out to be a safe and useful therapeutic tool to deal these kind of abdominal wall defects. Its issues are almost non-existent and it means a great advantage in the eventration’s surgery.