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Preoperative Ultrasound Guided Botulinum Toxin A Injection for Complex Ventral Wall Hernia Repair: One Tertiary Care Center?s Approach

Christopher Nall, Dana Feraco, Shashin Doshi, Madeline Niblock

Purpose: To discuss the utility of administrating botulinum toxin A (Botox) as an adjunct to surgical repair of complex abdominal wall hernias. Through discussion of the ultrasound-guided procedural technique and outcome data of one tertiary care center, it is our intention to bring awareness to this newer therapeutic option to facilitate the performance of this procedure at other care centers on a larger scale.

Materials and Methods: The procedure method of ultrasound-guided Botox injections and clinical course at one institution will be discussed. Outcome data including complications, achievement of primary fascial closure, rate of hernia recurrence, and patient population will be presented.

Results: Preoperative ultrasound-guided botulinum toxin A injection is a safe and effective procedure in patients undergoing complex ventral abdominal wall hernia repair that helps facilitate primary closure of large abdominal wall defects.

Conclusion: Awareness of this safe and effective preoperative image-guided procedure will help facilitate performance of this technique at more care centers, increasing the likelihood of primary closure of abdominal wall defects in more patients with large complex ventral hernias.