Combination of botulinum toxin A, progressive pre‐operative pneumoperitoneum for the repair of loss domain inguinal hernias

Gonzalo, Azucena; Navarro, Ana; Marín, Juan Ignacio; Pola, Guillermo; Martínez, Blanca

doi:10.1111/ans.14806

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…This strategy was implemented and extrapolated from previous experience in the management of complex ventral hernias [15]. BTA as an adjunct modality for the management of giant inguinoscrotal hernias has been previously described, but the literature remains scarce [13,[28][29][30].…”

Section: Discussionmentioning

confidence: 99%

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Botulinum Toxin A as an Adjunct for the Repair Giant Inguinal Hernias: Case Reports and a Review of the Literature

Huerta,

Raj,

Chang

2024

JCM

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The management of giant inguinoscrotal hernias remains a challenge as a result of the loss of the intra-abdominal domain from long-standing hernia contents within the scrotum. Multiple techniques have been described for abdominal wall relaxation and augmentation to allow the safe return of viscera from the scrotum to the intraperitoneal cavity without adversely affecting cardiorespiratory physiology. Preoperative progressive pneumoperitoneum, phrenectomy, and component separation are but a few common techniques previously described as adjuncts to the management of these massively large hernias. However, these strategies require an additional invasive stage, and reproducibility remains challenging. Botulinum toxin A (BTA) has been successfully used for the management of complex ventral hernias. Its use for these hernias has shown reproducibility and a low side effect profile. In the present report, we describe our institutional experience with BTA for giant inguinal hernias in two patients and present a review of the literature. In one case, a 77-year-old man with a substantial cardiac history presented with a giant left inguinal hernia that was interfering with his activities of daily living. He had BTA six weeks prior to inguinal hernia repair. Repair was performed via an inguinal incision with a favorable return of the viscera into the peritoneum. He was discharged on the same day of the operation. A second patient, 78 years of age, had a giant right inguinoscrotal hernia. He had a significant cardiac history and was treated with BTA six weeks prior to inguinal hernia repair via a groin incision. Neither patient had complaints nor recurrence at 7- and 3-month follow-ups. While the literature on this topic is scarce, we found 13 cases of inguinal hernias treated with BTA as an adjunct. BTA might be a promising adjunct for the management of giant inguinoscrotal hernias in addition to or in place of current strategies.

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Section: Discussionmentioning

confidence: 99%

“…In four prior reports, BTA was used in combination with PPP [28][29][30][31]. One report described the successful management of giant inguinoscrotal hernias in eight patients with a combination of PPP and BTA.…”

Section: Discussionmentioning

confidence: 99%

Botulinum Toxin A as an Adjunct for the Repair Giant Inguinal Hernias: Case Reports and a Review of the Literature

Huerta,

Raj,

Chang

2024

JCM

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“…Authors continue to describe BTX use for various other general surgical procedures. A number of authors have documented their successful use of BTX to help with the repair of challenging inguino-scrotal hernias (34)(35)(36)(37), as well as abdominal wall defects in children (38,39) and in the practise of giant hiatus hernia repair (40).…”

Section: Discussionmentioning

confidence: 99%

The Use of Botulinum Toxin in Complex Hernia Surgery: Achieving a Sense of Closure

Whitehead-Clarke

Windsor

2021

Front. Surg.

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Abdominal wall surgeons have developed a host of tools to help facilitate fascial closure. Botulinum toxin A is one of the most recently identified treatments and has grown in popularity over recent years; showing great promise in a number of case series and cohort studies. The toxin paralyses lateral abdominal wall muscles in order to increase laxity of the tissues—facilitating medialisation of the rectus muscles. Several research groups around the world are developing expertise with its use-uncovering its potential. We present a review of the relevant literature over the last two decades, summarising the key evidence behind its indications, dosing and effects.

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Prehabilitation of complex ventral hernia patients with Botulinum: a systematic review of the quantifiable effects of Botulinum

Wegdam

Reilingh

Bouvy

et al. 2020

Hernia

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Combination of botulinum toxin A, progressive pre‐operative pneumoperitoneum for the repair of loss domain inguinal hernias

Cited by 4 publications

References 5 publications

Botulinum Toxin A as an Adjunct for the Repair Giant Inguinal Hernias: Case Reports and a Review of the Literature

Botulinum Toxin A as an Adjunct for the Repair Giant Inguinal Hernias: Case Reports and a Review of the Literature

The Use of Botulinum Toxin in Complex Hernia Surgery: Achieving a Sense of Closure

Prehabilitation of complex ventral hernia patients with Botulinum: a systematic review of the quantifiable effects of Botulinum

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