Neumoperitoneo en el tratamiento de hernias gigantes

Abstract

El uso del neumoperitoneo preoperatorio progresi- vo ha demostrado ser una técnica útil y eficaz para el tratamiento de grandes defectos de la pared abdominal. Está indicado en hernias gigantes, pacientes de alto riesgo quirúrgico y grandes defectos recidivados. Se describe a 4 pacientes en los que se empleó neumoperitoneo progresivo realizado bajo anestesia local y sedación entre 1 y 3 semanas antes de la cirugía, seguido del tratamiento del defecto herniario con malla preperitoneal. Dos pacientes en régimen ambulatorio y 2 hospitalizados. No se detectaron complicaciones postoperatorias. Durante el seguimiento (10 meses-11 años) no hubo evidencias de recidiva.

eum has been demonstrated to be safe and effective in the treatment of large hernias. The indications for this technique include massive hernias, hernias in patients with high surgical risk, and large recurrent hernias. We describe four patients in whom progressive pneumoperitoneum was carried out under local anesthesia and sedation between 1 and 3 weeks before surgery. All four hernias were closed with a preperitoneal mesh. Insufflation was performed on an inpatient basis in two patients and in the ambulatory setting in one. No postoperative complications were detected. No evidence of recurrence was found during follow-up (10 months-11 years).