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Preoperative Ultrasound-Guided Botulinum Toxin A Injection Facilitates Closure of a Complex Abdominal Wall Hernia: A Case Report. A&A practice Tamboli, M. n., Kitamura, R. n., Ma, W. n., Kumar, G. n., Harrison, T. K., Wang, R. R., Mariano, E. R., Leng, J. C. 2019

Abstract

Complex abdominal wall hernia repairs can have high failure rates. Many surgical techniques have been proposed with variable success. We report our experience with a new collaborative protocol between general surgery and regional anesthesiology and acute pain medicine services to provide preoperative botulinum toxin A injections to a patient with a large complex ventral hernia to facilitate primary closure. Toxin was administered into the 3 abdominal wall muscle layers under ultrasound guidance at multiple sites 2 weeks before surgery. The resulting flaccid paralysis of the abdominal musculature facilitated a successful primary surgical closure with no postoperative complications.

View details for DOI 10.1213/XAA.0000000000001033

View details for PubMedID 31180908