Preoperative Ultrasound-Guided Botulinum Toxin A Injection Facilitates Closure of a Complex Abdominal Wall Hernia: A Case Report. Issue 5 (1st September 2019)

• Record Type: Journal Article
• Authors: Tamboli, Mallika; Kitamura, Riley; Ma, Wendy; Kumar, Gunjan; Harrison, T. Kyle; Wang, Rachel R.; Mariano, Edward R.; Leng, Jody C.
• Is Part Of: A & A practice. Volume 13:Issue 5(2019)
• Publication Date: 2019-09-01
• Subjects: Analgesia -- Periodicals; Analgesia -- Case studies -- Periodicals; Anesthesiology -- Periodicals; Anesthesiology -- Case studies -- Periodicals; 617.9605
• DOI: 10.1213/XAA.0000000000001033
• Languages: English
• ISSNs: 2575-3126

Abstract

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.