Hernia with loss of domain complicated resolved with preoperative progressive pneumoperitoneum. A case report

Background: The management of giant incisional hernias represents a challenge due to the physiological repercussions that reducing them can bring. Progressive preoperative pneumoperitoneum (PPP) aims to enlarge the volume of the abdominal cavity for surgical preparation of patients with large hernias, especially in cases of loss of control.

We present the case of a 77-year-old woman, with intestinal occlusion secondary to an incarcerated hernia with loss of dominance, managed with progressive preoperative pneumoperitoneum, with subsequent abdominal wall repair with separation of components with transverse muscle release; with the aim of demonstrating the good results. A systemic and descriptive bibliographic review was executed, through the meta-search engines: PUBMED, MEDLINE, SCIELO, PAHO and WHO published in the last 6 years (2018 to 2023), by goléanos “pneumoperitoneum and hernia”, “Tanaka score or hernia”, “Incisional hernia” and “Giant incisional hernia”. Thirty-two articles were retrieved, after the application of the inclusion and exclusion criteria, 20 original titles were selected.

Keywords: Hernia, abdominal wall, pneumoperitoneum, transverse muscle and surgical approach.