Evidence map›Paper›PMID 27572061›Full record

ArticleSurgical endoscopy2017

Preoperative progressive pneumoperitoneum complementing chemical component relaxation in complex ventral hernia repair.

Kristen E Elstner, John W Read, Omar Rodriguez-Acevedo, Kevin Ho-Shon, John Magnussen, Nabeel Ibrahim

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 6 pooled it
7.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 6 syntheses or guidelines pooled it, 78 citations in OpenAlex.

  1. Pooled it
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  3. Pooled it
  4. Pooled it
  5. A systematic review of the use of progressive preoperative pneumoperitoneum since its inception.Hernia : the journal of hernias and abdominal wall surgery · 2021
    Pooled it
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  10. Review
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  15. Complex Abdominal Wall Hernias: Structured Use of Adjuvant Therapies.Journal of abdominal wall surgery : JAWS · 2025
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  16. Observational
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  19. Review
  20. Tanaka score predicts surgical intensive care admission following abdominal wall reconstruction.Hernia : the journal of hernias and abdominal wall surgery · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Kristen E ElstnerMacquarie University Hospital, Technology Place, Macquarie, NSW, Australia.
John W ReadCastlereagh Imaging, St Leonards, NSW, Australia.
Omar Rodriguez-AcevedoHernia Institute Australia, Edgecliff, NSW, Australia.
Kevin Ho-ShonMacquarie Medical Imaging, Macquarie University Hospital, Macquarie, NSW, Australia.
John MagnussenMacquarie Medical Imaging, Macquarie University Hospital, Macquarie, NSW, Australia.
Nabeel IbrahimMacquarie University Hospital, Technology Place, Macquarie, NSW, Australia. Dri@zip.com.au.
Macquarie University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA rarely used technique for enabling closure of large ventral hernias with loss of domain is preoperative progressive pneumoperitoneum (PPP), which uses intermittent insufflation to gradually stretch the contracted abdominal wall muscles, increasing the capacity of the abdominal cavity. This allows the re-introduction of herniated viscera into the abdominal cavity and assists in closure of giant hernias which may otherwise be considered inoperable.

methodsThis was a prospective study assessing 16 patients between 2013 and 2015 with multi-recurrent ventral hernia. All patients were treated preoperatively with both Botulinum Toxin A (BTA) injections to the lateral abdominal wall muscles to confer flaccid paralysis, and short-term PPP to passively expand the abdominal cavity. All patients underwent serial abdominal CT imaging, with pre- and post-treatment circumference measurements of the peritoneal cavity and hernia sac, prior to undergoing operative mesh repair of their hernia.

resultsThe mean hernia defect size was 236 cm

conclusionsPPP is a useful adjunct in the repair of complex ventral hernia. It passively expands the abdominal cavity, allowing viscera to re-establish right of domain. At the same time, it helps to minimize the risks of postoperative abdominal compartment syndrome and the sequelae of fascial closure under tension. However, its benefits must be carefully weighed with the risk of serious complications, such as infection, perforation, pneumothorax, and pneumomediastinum.

Indexed as

Abdominal MusclesSurgical MeshAbdominal CavityAbdominal WallAcidosisAdultAgedBotulinum Toxins, Type AFemaleHernia, VentralHerniorrhaphyHumansInjections, IntramuscularInsufflationMaleMediastinal EmphysemaBotulinum Toxins, Type ANeuromuscular AgentsBotulinum toxin AComplex ventral herniaIncisional herniaLoss of domainPreoperative progressive pneumoperitoneum

Identifiers

PMID27572061
OpenAlexW2517407503

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.