Preoperative combination of progressive pneumoperitoneum and botulinum toxin type A in patients with loss of domain hernia

Abstract

Using a CT volumetric protocol, combination of PPP and BT decreases the VIH/VAC ratio and hernia defect diameters, which constitutes a key factor in the treatment of LODH.

The use of botulinum toxin A in chemical component separation: a review of techniques and outcomes

“…Our search yielded 47 articles, and 10 met our inclusion criteria for review [14,[16][17][18][19][20][21][22][23][24] . Two independent reviewers assessed the articles for inclusion.…”

“…Injection sites ranged from 3-5 points on each side of the abdomen. Six studies injected BTA into all three muscle layers of the abdominal wall for each injection site [17][18][19][20][21]23] . Elstner et al [22] compared injection at all three of the external oblique (EO), internal oblique (IO), and transversus abdominis (TA) muscles, to injection at only the EO and IO.…”

“…Bueno-Lledó et al [20] 2018 70 166 units* 10 total, 5 sites bilaterally, 16.6 U/5 mL per site, divided between EO, IO, and TA* 4 weeks prior to surgery Elstner et al [22] 2020 46 200 units 6 total, 3 sites bilaterally at EO, IO, and TA, or 6 total, 3 sites bilerally at EO and IO…”

What exactly is meant by ‘loss of domain’ for ventral hernia? A survey of 100 surgeons

“…The term ‘loss of domain’ (LOD) is used widely amongst surgeons to describe the relationship between ventral hernia (VH) volume and residual abdominopelvic cavity volume; hernias with significant LOD are difficult to repair and are more likely to recur . However, the term appears loosely defined: A recent systematic review demonstrated considerable confusion, finding multiple different written and volumetric definitions .…”

“…primary fascia closure) becomes clinically significant. It is claimed that LOD is a useful prognostic factor for recurrence but, for this to be true, a threshold value should be identified and recognized.…”