Progressive pneumoperitoneum in the management of giant incisional hernias: A study of 41 patients

Forty‐one patients (17 men and 24 women) were treated with progressive pneumoperitoneum before repair of giant incisional hernias. The pneumoperitoneum was induced using nitrous oxide gas and a laparoscopic insufflator, and was topped up every other day for a mean of 5·5 days with a total injection of 23·2 litres of nitrous oxide. The pneumoperitoneum was well tolerated in 30 patients, caused a mild temporary pain in 10 patients and a sharp pain in one patient; no serious side‐effects occurred. All the patients underwent surgery to repair their hernias, 40 patients were available for follow‐up for a mean of 25·3 months, only two hernias recurred both within 4 months of the operation.