Use of progressive pneumoperitoneum in the treatment of giant abdominal hernias

The preoperative use of progressive pneumoperitoneum in the treatment of large or complicated ventral hernias is established to be safe and useful. Indications for use of this technique include massive hernias, hernias that are repaired in a contaminated field, hernias in patients considered poor operative risks, and recurrent hernias. Five patients are described in whom this technique was used; all five hernias were closed primarily without tension, mesh, or postoperative complications. follow-up reveals no evidence of recurrence.