Identificazione di un parametro obiettivo di riferimento per la ricostruzione secondo criteri fisiologici del grande laparocele Ann.

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COD: 031-38 Categorie: ,

N. Picardi, G. Sigismondi, S. Di Paolo, M. Vene, R. Visini

Ann. Ital. Chir., LXXVI, 1, 2005

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Repairing a parietal defect of a large incisional hernia
should not be limited to the closure of the breach by means
of the modern biocompatible prosthetic sheets, but must also
be able to restore a correct intra abdominal pressure,
otherwise the derangement from the normal respiratory
dynamics and the circulatory stasis in the abdominal veins
and in those of the lower limbs remain unaltered.
Overcorrecting the parietal abdominal tension on the contrary
can cause a dangerous compartimental syndrome.
The attempts of an intraoperative measurement of the correct
intra abdominal pressure restoration has been generally
hampered from the condition of curarization of the
patient during the operation.
Using the automatic mechanical ventilator fixed at volume
and not at pressure priority, as usual, can offer the possibility
to calibrate, following objective parameters, the propriety
of the surgical repair still during the final phases of
the reparative operation.
The simplicity and ingenuity of the here proposed method
and the normal availability in every operative theatre of the
necessary means for this measurements descrive of attention
among the surgeons and a large diffusions of its simple use.

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