A 78-year-old woman with a BMI of 30.5 and a history of cholecystectomy through a right subcostal incision 42 years previously and umbilical hernioplasty 4 years ago. She currently has an M2-3-4W2R1 eventration (Fig. 1) and a Tanaka index of 28% and is a candidate for preoperative pneumoperitoneum. After 72 hours of daily insufflation of 1 litre, the patient began with dyspnoea and underwent an abdomen-chest X-ray, showing massive right pneumothorax (Fig. 2), requiring chest drainage and hospital admission. The patient progressed favourably and was discharged on the 6th day.
Close follow-up, maintaining a high degree of suspicion is important to identify and treat complications early. In most cases, these do not make it impossible to complete the surgery successfully. However, in our case, it did prevent us from continuing with the anticipated preoperative plan and caused us to definitively reject surgery.
