LAUSR

Voluminous inguinoscrotal hernias that have lost their “right of domain”, are usually hard to repair, and need preoperative preparations to reduce the risk of complications after the treatment, such as compartment syndrome, intestinal ischemia, and respiratory problems. In this e-poster, we present a case report of a patient who had a voluminous inguinoscrotal hernia containing most of the small intestine and the entire right colon, which we treated after a preoperative pneumoperitoneum preparation (PPP). The preparation was conducted 20 days before the surgery and the pneumoperitoneum was created through a percutaneous catheter that we inserted in the epigastric region after a radiologic control. We injected 1000 ml of air per day, and the dose was adapted to the clinical tolerance of the patient. We performed a reintegration of the hernia's volume, a resection of the hernial sac, and a reduction of the size othe profound inguinal ring via a Raphia, no intestinal resections were made, and the postoperative course was uneventful. We plan a second intervention that consists of a hernia repair by a mesh insertion and a resection of the extra skin developed as a result of the voluminous hernia. PPP is an interesting way to prepare the abdominal cavity to receive the component of a voluminous hernia after its reduction. The patient should be closely monitored during the preparation and after the surgery in order. Sometimes a second operation is necessary for definitive cure or aesthetic needs.