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- Mallika Tamboli, Riley Kitamura, Wendy Ma, Gunjan Kumar, T Kyle Harrison, Rachel R Wang, Edward R Mariano, and Jody C Leng.
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California.
- A A Pract. 2019 Sep 1; 13 (5): 193-196.
AbstractComplex 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.
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