Pneumoperitoneum

A SAFE and easy approach to the repair of large abdominal hernias is first to prepare the patient with progressive pneumoperitoneum. This seems to be particularly true in patients with chronic pulmonary disease. This procedure was first reported by Ivan Goni Moreno in 1940.¹,²Since that time progressive pneumoperitoneum has been frequently described in foreign literature³⁻⁷; yet, only four papers have been presented on this subject in American literature in the past ten years.⁸⁻¹¹It is obvious that the procedure has not received the attention it deserves. Also of note are reports indicating the efficacy of this technique for repair of ompholoceles.¹²⁻¹⁶This paper will present our successful experience with pneumoperitoneum in the repair of 21 large abdominal hernias in the hope that others may be encouraged to employ it. Rationale Repairing or attempting to repair giant ventral, umbilical, incisional, or inguinal hernias can be a