Preoperative progressive pneumoperitoneum: insights on implementation in an ambulatory care setting. How I do it?
- 01.12.2025
- How-I-Do-It
Erschienen in:
- Verfasst von
- Alix Donadieu
- Fahad Alhammadi
- Alicia Mettoudi
- Annie Garois
- Reza Kianmanesh
- Ahmad Tashkandi
- Yohann Renard
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Introduction
Incisional hernias with loss of domain (IHLD) are challenging to treat. Preoperative techniques like botulinum toxin injection (BTA) and preoperative progressive pneumoperitoneum (PPP) are highly effective, potentially preventing the need for perioperative component separation in the vast majority of cases. PPP involves preoperative introduction of gas into the abdominal cavity to increase the abdominal wall volume, aiding diaphragmatic prehabilitation and hernia reintegration. This study aimed at explaining our technique in performing PPP in ambulatory setting.
Description of the technique
The first insufflation and BTA injection occur during a 3-day hospitalization. Subsequently, patients are managed on an ambulatory basis with three sessions per week for at least three weeks. Each hospital visit lasts about 1 to 2 h. Patients can remain at home or in a residential center of our hospital. No preventive anticoagulation nor prophylactic antibiotics are needed.
Discussion
Performing PPP in outpatient care does not compromise its efficacy. Instead, it allows for longer preparation, potentially improving efficacy. Patients maintain daily activities, possibly yielding better results than traditional physiotherapy. It reduces hospital stay costs and nosocomial infection risks. Each ambulatory hospitalization offers better patient attention.
Conclusions
PPP is a valuable preoperative technique for IHLD repair, particularly in combination with botulinum toxin, offering potential benefits for selected patients. Performing it in outpatient care may enhance patient satisfaction and offers several advantages.
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- Titel
- Preoperative progressive pneumoperitoneum: insights on implementation in an ambulatory care setting. How I do it?
- Verfasst von
-
Alix Donadieu
Fahad Alhammadi
Alicia Mettoudi
Annie Garois
Reza Kianmanesh
Ahmad Tashkandi
Yohann Renard
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-024-03253-z
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