A treatment protocol for giant ventral hernias based on predicted postoperative respiratory function
Year: 2026
Type: article
Abstract: Background: Giant ventral hernias and loss-of-domain abdominal wall defects remain challenging because reintegration of hernia contents may increase intra-abdominal pressure and impair postoperative respiratory function. Methods/protocol: We describe a structured institutional protocol that integrates abdominopelvic CT volumetry, the hernia sac/abdominal cavity volume ratio, respiratory function testing during progressive simulated abdominal occupation, preoperative botulinum toxin, progressive pneumoperitoneum, transversus abdominis release and, only in selected high-risk cases, volume transposition. Clinical implications: The protocol is intended to support individualized surgical planning by estimating both abdominal and respiratory consequences before definitive reconstruction. Conclusions: This manuscript should be interpreted as a methodological protocol and feasibility proposal rather than a validated predictive clinical model. Prospective validation with standardized endpoints is ongoing and will be required before the thresholds can be considered externally validated.
Source: Frontiers in Surgery
Language: English
Topic: Hernia repair and management
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7221505383