Some patients with abdominal wall hernias have such large hernias that they are called "giant" hernias, commonly defined as a hernia greater than 10 cm in any dimension. These giant hernias can also be associated with loss of domain. When there is loss of domain, the abdominal cavity is no longer able to fully accommodate the body's internal organs, sometimes to the point where more organ tissue is outside the cavity than within it. This make repair of the hernia extremely difficult. Closure of the hernia defect and returning the internal organs to the abdominal cavity can lead to an increased risk of recurrence and risk for abdominal compartment syndrome, a serious complication caused by high abdominal pressures because the closure is too tight.

The UCSF Hernia Center provides the latest treatments for complex ventral hernias, such as the preoperative progressive pneumoperitoneum hernia repair, a specialized approach for treating giant hernias.

The preoperative progressive pneumoperitoneum technique is a safe and effective pre-operative procedure that prepares the patient's abdominal cavity for the return of the hernia sac organs back into the abdominal cavity, enabling a successful surgical repair. This is a complex procedure that is only utilized at a handful of specialized hernia centers around the country including UCSF.

For More Information

Ventral Hernia Repair (American College of Surgeons)

Complex Abdominal Surgery Program