The place for pneumoperitoneum in the repair of massive hernia

Progressive pneumoperitoneum before the repair of massive abdominal and inguinal hernias, first introduced in 1940, remains an important technique in preparing patients for the operation. Reports of its use have appeared sporadically in the surgical literature. This article recounts the technique of progressive preoperative pneumoperitoneum, its advantages and complications, and the variety of situations in which it is useful. Surgeons treating large hernias accompanied by loss of domain of abdominal viscera should consider preoperative progressive pneumoperitoneum as a helpful and often necessary adjunct to hernial repair.