CRCM  Vol.1 No.2 , December 2012
Progressive pre-operative pneumoperitoneum is not necessary for large inguinoscrotal hernia repair: Report of a case
Abstract: Huge inguinoscrotal hernias are a challenging operation. The technical aspects of the procedure can be very difficult and the recovery may be complicated by ventilatory problems. Progressive preoperative pneumoperitoneum (PPP) is a method which has been used for many years to reduce both intra and postoperative complications. However, it is associated with a prolonged preoperative hospital stay which is expensive and often stressful to patients. We report a case of a morbidly obese patient with a huge inguinoscrotal hernia. PPP was not implemented. The operation was uneventful and he was discharged 8 days later with no major post-operative complications. This case therefore questions the necessity of PPP for huge inguin- oscrotal hernias.
Cite this paper: Panteleimonitis, S. , Ihedioha, U. , Mann, C. , Gechev, Z. and Finch, G. (2012) Progressive pre-operative pneumoperitoneum is not necessary for large inguinoscrotal hernia repair: Report of a case. Case Reports in Clinical Medicine, 1, 6-8. doi: 10.4236/crcm.2012.12003.

[1]   Vasiliadis, K., Knaebel, H.P., Djakovic, N., Nyarangi-Dix, J., Schmidt, J. and Büchler, M. (2010) Challenging surgical management of a giant inguinoscrotal hernia: Report of a case. Surgery Today, 40, 684-687. doi:10.1007/s00595-009-4125-3

[2]   Serpell, J.W., Polglase, A.L. and Anstee, E.J. (1988) Giant inguinal hernia. Australian and New Zealand Journal of Surgery, 58, 831-834. doi:10.1111/j.1445-2197.1988.tb00988.x

[3]   Hodgkinson, D.J. and McIlrath, D.C. (1980) Scrotal re- construction for giant inguinal hernias. Surgical Clinics of North America, 64, 307-313.

[4]   Edward, E.M. and Merril, T.D. (1989) Pneumoperitoneum in giant hernia. In: Nyhus, L.M. and Condon, R.E., Eds., Hernia, 3rd Edition, Lippincott, Philadelphia, 36, 521-530.

[5]   Mayagoitia, J.C., Suárez, D., Arenas, J.C. and Díaz de León, V. (2006) Preoperative progressive pneumoperitoneum in patients with abdominal-wall hernias. Hernia, 10, 213-217. doi:10.1007/s10029-005-0040-8

[6]   Forrest, J. (1979) Repair of massive inguinal hernia. Archives of Surgery, 114, 1087-1088. doi:10.1001/archsurg.1979.01370330109021

[7]   El Saadi, A.S., Al Wadan, A.H. and Hamerna, S. (2005) Approach to a giant inguinoscrotal hernia. Hernia, 9, 277-279. doi:10.1007/s10029-004-0291-9

[8]   Kyle, S.M., Lovie, M.J. and Dowle, C.S. (1990) Massive inguinal hernia. British Journal of Hospital Medicine, 43, 383-384.

[9]   Barst, H.H. (1972) Pneumoperitoneum as an aid in the surgical treatment of giant herniae. British Journal of Surgery, 59, 360-364. doi:10.1002/bjs.1800590507

[10]   Goni Moreno, I.G. (1978) The rational treatment of hernias and voluminous chronic eventrations: Preparation with progressive pneumoperitoneum. In: Nyhus, L.M. and Condon, R.E., Eds., Hernia, 2nd Edition, Lippincott, Philadelphia, 536-560.

[11]   Goni Moreno, I. (1947) Chronic eventration and large hernias: Preoperative treatment by progressive pneumoperitoneum-original procedure. Surgery, 22, 945-953.

[12]   Raynor, R.W. and Del Guercio, L.R. (1989) The place for pneumoperitoneum in the repair of massive hernia. World Journal of Surgery, 13, 581-585. doi:10.1007/BF01658874

[13]   Kovachev, L.S., Paul, A.P., Chowdhary, P., Choudhary, P. and Filipov, E.T. (2010) Regarding extremely large inguinal hernias with a contribution of two cases. Hernia, 14, 193-197. doi:10.1007/s10029-009-0517-y

[14]   Herszage, L. (2003) Abordaje de las eventraciones de pared. In: Mayagoitia, J.C., Ed., Hernias de la Pared Abdominal. Tratamiento Actual, McGraw-Hill, Mexico, 201-212.

[15]   Beitler, J.C., Gomes, S.M., Coelho, A.C. and Manso, J.E. (2009) Complex inguinal hernia repairs. Hernia, 13, 61-66. doi:10.1007/s10029-008-0432-7

[16]   Merrett, N.D., Waterworth, M.W. and Green, M.F. (1994) Repair of giant inguinoscrotal inguinal hernia using mar- lex mesh and scrotal skin flaps. Australian and New Zealand Journal of Surgery, 64, 380-383. doi:10.1111/j.1445-2197.1994.tb02231.x