Role of progressive preoperative pneumoperitoneum in the management of giant inguinoscrotal hernia-case report


  • Sabari Girieasen M. Institute of General Surgery, MMC, Chennai, Tamil Nadu, India
  • Vijayalakshmi V. Institute of General Surgery, MMC, Chennai, Tamil Nadu, India
  • Mohamed Farook M. Institute of General Surgery, MMC, Chennai, Tamil Nadu, India



Giant inguinoscrotal hernia, Hernia with loss of domain, Progressive preoperative pneumoperitoneum, PPP


Managing a giant inguinal hernia/ incisional/ ventral hernia had its own complications. The overtime adaptation of peritoneal cavity to a lower abdominal pressure was one of the most important factors responsible for these complications. Surgical repair is also quite a challenge because of the massive contents in sac, adhesions and concomitant fibrosis. In order to reduce the complications like intra-abdominal hypertension, cardiorespiratory problems and to increase the abdominal wall compliance, many techniques were described. Progressive preoperative pneumoperitoneum is a well described technique for the repair of giant inguinal hernia/ incisional/ ventral hernia with loss of domain which helps in conditioning the abdominal wall in the preoperative period, increasing the likelihood of primary closure and decreasing the incidence of compartment syndrome.


Moreno IG. Chronic eventrations and large hernias; preoperative treatment by progressive pneumoperitoneum; original procedure. Surgery. 1947;22-94:SS3.

Hodgkinson NJ, Mcllrath DC. Scrotal reconstruction for giant inguinal hernias. Surg Cnn North Am. 1984;64:307-13.

Trakarnsagna A, Chinswangwatanakul V, Methasate A, Swangsri J, Phalanusitthepha C, Parakonthun L et al. Giant inguinal hernia: Report of a case and reviews of surgical techniques. Int J Surg Case Rep. 2014;5:868-72.

Serpell JWI, Polglase AL Anstee EJ. Giant inguinal hernia. Aust N ZJ Surg. 1988;58:831-4.

Cavalli M, Biondi A, Bruni PG, Campanelli G. Giant inguinal hernia: the challenging hug technique.Hernia J Hernias Abdom Wall Surg. 2015;19(77):583.

Moss G. Letter to the editors: Techniques to aid in hernia repair complicated by «loss of domain. Surgery. 1975;78:408.

Karthikeyan VS, Sistla SC, Ram D, Ali SM, Rajkumar N. Giant Inguinoscrotal Hernia-Report of a Rare Case with Literature Review. Int Sure. 2014;99:560-64.

Turgut P, Cemalettin A, Bora B, Abuzer D, Cuneyt K. Case report Preoperative progressive pneumoperitoneum for giant inguinal hernias. Ann Saudi Med. 2010;30(4):317-20.

Musgrove KA, Burchard PR, Bergstrom DC. Progressive Preoperative Pneumoperitoneum for Giant Inguinoscrotal Hernia: A Case Report and Literature Review. ACS Case Rev Surg. 2018;1(4):28-31.

Aguirre JE, Ruiz-Nino H, Maria MM, Jose AC, Jorge JP. Case report: preoperative progressive pneumoperitoneum in giant inguinoscrotal Hernia. Arch Clin Exp Surg. 2018;7(2):84-8.






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