P-045 OUR EXPERIENCE WITH THE PREOPERATIVE PROGRESSIVE PNEUMOPERITONEUM

Abstract Aim Complex incisional hernias (IH) pose a surgical challenge. Prehabilitation of the abdominal wall favors surgery and improves outcomes. We present our results with use preoperative progressive pneumoperitoneum (PPP) in complex pathology. Material Methods Single-centre, retrospective, observational study (March 2018-July 2022), including patients receiving PPP (Tanaka index >20% or <20% if facing non-reducible incarcerated IH). The insufflation catheter is placed under ultrasound control, initially administering 500 cc. total volume to be administered three times hernia sac. Administration effectuated on an outpatient basis, starting 15 days before surgery, 1000–1200 cc every 24–48 hours. Antithrombotic prophylaxis, incentive inspirrometry prescribed analgesia are performed. Results 68 were included, 39 females/29 males, age 63.3 years (24–85), body mass 33.7 (20–48) CeDAR 38.9% (11–92). Classification IH (EHS): M 72% (49), L 15% (10), ML 6% (4), parastomal 4% (3), groin (3) other primary 3% (2). Mean Tanaka 26% (3–85), mean insufflated 3395 (1800–15000 cc). time was 14 (3–70). Eight complications related procedure observed: 3 subcutaneous emphysema (4.3%), 2 ineffective (2.8%), 1 exit (1.4%), infection (1.4%) laparoscopic approach (1.4%). In cases it not feasible place catheter. Conclusions effective safe treatment facilitate repair IH, minimal morbidity zero mortality.