The first experience of use botulinum toxin type a in the surgical treatment of ventral hernias
DOI:
https://doi.org/10.11603/2414-4533.2020.2.10775Keywords:
hernia, botulinum toxin, hernioplastyAbstract
The aim of the work: to study the experience of using type A botulinum toxin in the surgical treatment of ventral hernias.
Materials and Methods. In the clinic of the Department of General Surgery No. 2 of O. Bohomolets National Medical University a prospective study was conducted and included 9 patients. All patients underwent treatment from June 2017 to December 2018 for ventral hernia. In 7 (77.8 %) patients, a postoperative ventral hernia was diagnosed, in 1 (11.1 %) patient – a recurrent postoperative ventral hernia, in 1 (11.1%) patient – a giant ventral hernia of the white line of the abdomen. All patients received an injection of type A botulinum toxin into the muscles of the anterior abdominal wall as a preoperative preparation. Changes regarding the size of the hernial defect were evaluated after 4 weeks from the moment of injection using objective examination, ultrasound and computed tomography of the abdominal wall.
Results and Discussion. 4 weeks after the intramuscular injection of botulinum toxin type A, a significant decrease in the size of the hernial defect was observed in all patients according to computed tomography (p <0.001). On average, the thickness of the abdominal wall on the right side decreased by (1.45±1.05) mm, on the left – by (1.22±0.97) mm. A significant increase in the length of the muscles of the anterior abdominal wall was observed on average by (16.68±12.84) mm on the right side and (16.54±11.65) mm on the left side. The use of botulinum toxin in preoperative preparation made it possible to avoid separation methods of hernioplasty in all patients and in 55.6 % of cases suturing of the hernial defect and hernioplasty were performed laparoscopically.
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