Abstract
Complex abdominal wall hernias are challenging clinical situations characterized by large fascial defects, lateral abdominal wall muscle retraction, and loss of abdominal domain. The use of botulinum toxin A to produce a flaccid paralysis or chemodenervation of the lateral abdominal wall has emerged as a promising tool in the hernia repair armamentarium to tackle these challenging situations in complex abdominal wall reconstruction. The effects of such temporary paralysis of the abdominal wall musculature have the potential benefits of decreasing intraabdominal pressure while increasing abdominal wall compliance and abdominal domain. The available published evidence remains sparse but several interesting preclinical and clinical observations have been made which provide insights into the potential role of botulinum toxin A in hernia surgery. Herein, we synthetize the available evidence, provide recommendations for its use, and stimulate further research in the area.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Walker TJ, Dayan SH. Comparison and overview of currently available neurotoxins. J Clin Aesthet Dermatol. 2014;7:31–9.
Dover N, Barash JR, Hill KK, Xie G, Arnon SS. Molecular characterization of a novel botulinum neurotoxin type H gene. J Infect Dis. 2014;209:192–202.
Truong D, Dressler D, Hallet M, editors. Manual of botulinum toxin therapy. Cambridge: Cambridge University Press; 2009. p. 234.
Jankovic J, Albanese A, Atassi MZ, Dolly JO, Hallett M, Mayer NH. Botulinum toxin: therapeutic clinical practice and science. Philadelphia: Saunders; 2009.
Scott AB. Botulinum toxin injection into extraocular muscles as an alternative to strabismus surgery. J Pediatr Ophthalmol Strabismus. 1980;17:21–5.
Ibarra-Hurtado TR, Nuño-Guzmán CM, Echeagaray-Herrera JE, Robles-Vélez E, de Jesús G-JJ. Use of botulinum toxin type a before abdominal wall hernia reconstruction. World J Surg. 2009;33:2553–6.
Slater NJ, Montgomery A, Berrevoet F, et al. Criteria for definition of a complex abdominal wall hernia. Hernia. 2014;18:7–17.
Lien SC, Hu Y, Wollstein A, Franz MG, Patel SP, Kuzon WM, Urbanchek MG. Contraction of abdominal wall muscles influences size and occurrence of incisional hernia. Surgery. 2015;158:278–88.
Cakmak M, Caglayan F, Somuncu S, Leventoglu A, Ulusoy S, Akman H, Kaya M. Effect of paralysis of the abdominal wall muscles by botulinum A toxin to intraabdominal pressure: an experimental study. J Pediatr Surg. 2006;41:821–5.
Rodríguez-Ruiz G, Cruz-Zárate A, Oña-Ortiz FM, García-Arrona LR, Sánchez-Valle AA, Chávez-Villanueva UJ, Mata-Quintero CJ, Luna-Martínez J. Separación de componentes química (toxina botulínica tipo A) en la reparación de hernia ventral planeada: un modelo murino. Rev Hispanoam Hernia. 2015;3:139–46.
Smoot D, Zielinski M, Jenkins D, Schiller H. Botox A injection for pain after laparoscopic ventral hernia: a case report. Pain Med. 2011;12:1121–3.
Zendejas B, Khasawneh MA, Srvantstyan B, Jenkins DH, Schiller HJ, Zielinski MD. Outcomes of chemical component paralysis using botulinum toxin for incisional hernia repairs. World J Surg. 2013;37:2830–7.
Zielinski MD, Goussous N, Schiller HJ, Jenkins D. Chemical components separation with botulinum toxin A: a novel technique to improve primary fascial closure rates of the open abdomen. Hernia. 2013;17:101–7.
Zielinski MD, Kuntz M, Zhang X, et al. Botulinum toxin A-induced paralysis of the lateral abdominal wall after damage-control laparotomy: a multi-institutional, prospective, randomized, placebo-controlled pilot study. J Trauma Acute Care Surg. 2016;80:237–42.
Farooque F, Jacombs ASW, Roussos E, Read JW, Dardano AN, Edye M, Ibrahim N. Preoperative abdominal muscle elongation with botulinum toxin A for complex incisional ventral hernia repair. ANZ J Surg. 2016;86:79–83.
Verónica Chávez-Tostado K, Cárdenas-Lailson LE, Pérez-Trigos H. Resultado de la aplicación preoperatoria de toxina botulínica A en el tratamiento de hernias incisionales gigantes [Results of preoperative application of botulinum toxin type A in treatment of giant incisional hernias]. Rev Hispanoam Hernia. 2014;2:145–51.
Millet SB, Carr No Saenz O, De M, Burgu No J, Tatay FC. Empleo de toxina botulínica en pared abdominal como tratamiento previo a la reparación quirúrgica de una hernia de Morgagni gigante. Rev Hispanoam Hernia. 2015;3:65–9.
Ibarra Hurtado TR. Toxina botulínica A: su importancia en pacientes con grandes hernias abdominales. Rev Hispanoam Hernia. 2014;2:131–2.
Naumann M, Jankovic J. Safety of botulinum toxin type A: a systematic review and meta-analysis. Curr Med Res Opin. 2004;20:981–90.
Alam NN, Narang SK, Pathak S, Daniels IR, Smart NJ. Methods of abdominal wall expansion for repair of incisional herniae: a systematic review. Hernia. 2016. doi:10.1007/s10029-016-1463-0.
Fields AC, Gonzalez DO, Chin EH, Nguyen SQ, Zhang LP, Divino CM. Laparoscopic-assisted transversus abdominis plane block for postoperative pain control in laparoscopic ventral hernia repair: a randomized controlled trial. J Am Coll Surg. 2015;221:462–9.
Charlton S, Cyna A. Perioperative transversus abdominis plane (TAP) blocks for analgesia after abdominal surgery. Cochrane Database Syst Rev 2010;(12):CD007705.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Zendejas, B., Zielinski, M.D. (2017). Botulinum Toxin Use in Complex Abdominal Wall Hernias. In: Hope, W., Cobb, W., Adrales, G. (eds) Textbook of Hernia. Springer, Cham. https://doi.org/10.1007/978-3-319-43045-4_46
Download citation
DOI: https://doi.org/10.1007/978-3-319-43045-4_46
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-43043-0
Online ISBN: 978-3-319-43045-4
eBook Packages: MedicineMedicine (R0)