Rezumat Pneumoperitoneul progresiv terapeutic (PPT) ca adjuvant în tratamentul herniilor cu pierderea dreptului la domiciliu Introducere: închiderea foråatã a unui defect parietal de mari dimensiuni conduce la rezultate imediate şi tardive nesatisfãcã- toare în ciuda dezvoltãrii chirurgiei protetice. Creşterea dimen- siunilor abdomenului se poate realiza pe lângã alte metode, cu ajutorul pneumoperitoneului progresiv. Scopul studiului este de-a evalua rezultatele imediate ale utilizãrii metodei la pacienåii cu defecte parietale importante. Material şi metodã: în perioada iunie 1998 - iunie 2013, metoda s-a aplicat la 17 pacienåi (4 de sex masculin) cu hernii inghinale gigante (3 cazuri) sau hernii incizionale (14 cazuri) primare sau recidivate internaåi în secåia Chirurgie a Spitalului Militar de Urgenåa Cluj-Napoca. Vârsta medie 64,35 ani. S-au mãsurat constantele standard ale funcåiei respiratorii (CV, VEMS, VEMS/CV etc), gazele sanguine, presiunea intravezicalã înaintea injectãrii aerului, cu 24 de înainte de intervenåie şi la 7 zile postoperator. Rezultate: nu s-au consemnat accidente/complicaåii legate de metoda în sine. S-a obåinut ameliorarea semnificativã a funcåiei respiratorii şi creşterea proporåionalã a presiunii intraabdominale. Concluzii: rezultatele obåinute indicã metoda ca fiind de elecåie în crearea unei compatibilitãåi între conåinut şi conåinãtor la pacienåii cu defecte parietale gigante. Cuvinte cheie: hernie incizionalã, pierderea dreptului la domiciliu, pneumoperitoneu Abstract Background: forced repair of a giant abdominal wall defect end with unsatisfactory results despite development of prosthetics materials. The enlargement of abdominal wall dimensions could be realized altogether other methods with the aid of pneumo-peritoneum. The aim of the study is to evaluate early results of the method used for patients with giant incisional hernias. Material and methods: between june 1998 – june 2013, 17 patients (4 males) with giant abdominal wall defects (incisional and inguinal hernias) were prepaired for radical surgery with pneumoperitoneum. Average age was 64.35 years. Were evaluated the standard constants of the pulmonary function, blood gases, and intra-vesical pressure in 3 moments: before the first gas insuflation, 24 hours before surgery and in the 7 th day postoperatively. Results: the method was free of accidents or incidents, no mortality was recorded. The respiratory function was signifi- cantly increased and also the intra-abdominal pressure. Conclusion: our results suggest that the method of progressive pneumoperitoneum is safe, costless of choice for creating a clear compatibility between the wall and abdominal content in patients with giant abdominal wall defects. Also ensures a long term and stable improvement of the respiratory function in all it’s components. Key words: incisional hernias, loss of domain, pneumo- peritoneum Progressive Preoperative Pneumoperitoneum (PPP) as an Adjunct for Surgery of Hernias with Loss of Domain V. Oprea 1 , O. Matei 1 , D. Gheorghescu 1 , D. Leuca 1 , F. Buia 1 , M. Rosianu 1 , M. Dinca 2 1 Department of Surgery, “Constantin Papilian” Emergency Military Hospital, Cluj Napoca, Romania 2 Department of Pulmonary Diseases, “Constantin Papilian” Emergency Military Hospital, Cluj Napoca, Romania Chirurgia (2014) 109: 664-669 No. 5, September - October Copyright© Celsius Corresponding author: V. Oprea, MD No. 22, General Traian Mosoiu Street Cluj-Napoca, county Cluj, Romania E-mail: opreacv@yahoo.com