Preoperative Botulinum toxin A enabling defect closure and laparoscopic repair of complex ventral hernia
Introduction Operative management of complex ventral hernia still remains a significant challenge for surgeons. Closure of large defects in the unprepared abdomen has serious pathophysiological consequences due to chronic contraction and retraction of the lateral abdominal wall muscles. We report ou...
Gespeichert in:
| Veröffentlicht in: | Surgical endoscopy 2018-02, Vol.32 (2), p.831-839 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 839 |
|---|---|
| container_issue | 2 |
| container_start_page | 831 |
| container_title | Surgical endoscopy |
| container_volume | 32 |
| creator | Rodriguez-Acevedo, Omar Elstner, Kristen E. Jacombs, Anita S. W. Read, John W. Martins, Rodrigo Tomazini Arduini, Fernando Wehrhahm, Michael Craft, Colette Cosman, Peter H. Dardano, Anthony N. Ibrahim, Nabeel |
| description | Introduction
Operative management of complex ventral hernia still remains a significant challenge for surgeons. Closure of large defects in the unprepared abdomen has serious pathophysiological consequences due to chronic contraction and retraction of the lateral abdominal wall muscles. We report outcomes of 56 consecutive patients who had preoperative Botulinum toxin A (BTA) abdominal wall relaxation facilitating closure and repair.
Methods
This was a prospective observational study of 56 patients who underwent ultrasound-guided BTA into the lateral abdominal oblique muscles prior to elective ventral hernia repair between November 2012 and January 2017. Serial non-contrast abdominal CT imaging was performed to evaluate changes in lateral oblique muscle length and thickness. All hernias were repaired laparoscopically, or laparoscopic-open-laparoscopic (LOL) using intraperitoneal onlay mesh.
Results
56 patients received BTA injections at predetermined sites to the lateral oblique muscles, which were well tolerated. Mean patient age was 59.7 years, and mean BMI was 30.9 kg/m
2
(range 21.8–54.0). Maximum defect size was 24 × 27 cm. A subset of 18 patients underwent preoperative pneumoperitoneum as an adjunct procedure. A comparison of pre-BTA to post-BTA imaging demonstrated an increase in mean lateral abdominal wall length from 16.1 cm to 20.1 cm per side, a mean gain of 4.0 cm/side (range 1.0–11.7 cm/side) (
p
|
| doi_str_mv | 10.1007/s00464-017-5750-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1922509872</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1922509872</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-91da8fc6c71f59161fc3e7f4274343ca3207f0b900098e00004e79ba8e04310c3</originalsourceid><addsrcrecordid>eNp1kUtLAzEUhYMotlZ_gBsJuHEzmtc0k6WKLyjoQtchTW_qyEwyJjOl_ntTqiKCq4TkOyc59yB0TMk5JUReJELEVBSEyqKUJSn4DhpTwVnBGK120ZgoTgomlRihg5TeSMYVLffRiFWScymqMXp9ihA6iKavV4CvQj80tR9a3Id17fElBm_m-WSJF-DA9tg2IQ0RsPEL3JjOxJBs6GqLI3Smjjg4bEPbNbDGK_B9NA1-hehrc4j2nGkSHH2tE_Rye_N8fV_MHu8eri9nheWS9YWiC1M5O7WSulLRKXWWg3SCScEFt4YzIh2Zq5xFVUA2kUCqucl7wSmxfILOtr5dDO8DpF63dbLQNMZDGJKmirEyayXL6Okf9C0M0effZSqPbioY45miW8rmrCmC012sWxM_NCV6U4Pe1qBzDXpTg95oTr6ch3kLix_F99wzwLZAyld-CfHX0_-6fgKBRJJH</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1993064223</pqid></control><display><type>article</type><title>Preoperative Botulinum toxin A enabling defect closure and laparoscopic repair of complex ventral hernia</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Rodriguez-Acevedo, Omar ; Elstner, Kristen E. ; Jacombs, Anita S. W. ; Read, John W. ; Martins, Rodrigo Tomazini ; Arduini, Fernando ; Wehrhahm, Michael ; Craft, Colette ; Cosman, Peter H. ; Dardano, Anthony N. ; Ibrahim, Nabeel</creator><creatorcontrib>Rodriguez-Acevedo, Omar ; Elstner, Kristen E. ; Jacombs, Anita S. W. ; Read, John W. ; Martins, Rodrigo Tomazini ; Arduini, Fernando ; Wehrhahm, Michael ; Craft, Colette ; Cosman, Peter H. ; Dardano, Anthony N. ; Ibrahim, Nabeel</creatorcontrib><description>Introduction
Operative management of complex ventral hernia still remains a significant challenge for surgeons. Closure of large defects in the unprepared abdomen has serious pathophysiological consequences due to chronic contraction and retraction of the lateral abdominal wall muscles. We report outcomes of 56 consecutive patients who had preoperative Botulinum toxin A (BTA) abdominal wall relaxation facilitating closure and repair.
Methods
This was a prospective observational study of 56 patients who underwent ultrasound-guided BTA into the lateral abdominal oblique muscles prior to elective ventral hernia repair between November 2012 and January 2017. Serial non-contrast abdominal CT imaging was performed to evaluate changes in lateral oblique muscle length and thickness. All hernias were repaired laparoscopically, or laparoscopic-open-laparoscopic (LOL) using intraperitoneal onlay mesh.
Results
56 patients received BTA injections at predetermined sites to the lateral oblique muscles, which were well tolerated. Mean patient age was 59.7 years, and mean BMI was 30.9 kg/m
2
(range 21.8–54.0). Maximum defect size was 24 × 27 cm. A subset of 18 patients underwent preoperative pneumoperitoneum as an adjunct procedure. A comparison of pre-BTA to post-BTA imaging demonstrated an increase in mean lateral abdominal wall length from 16.1 cm to 20.1 cm per side, a mean gain of 4.0 cm/side (range 1.0–11.7 cm/side) (
p
< 0.0001). This corresponds to an
unstretched
mean length gain of 8.0 cm of the lateral abdominal wall. Laparoscopic/LOL primary closure was achieved in all cases, with no clinical evidence of raised intra-abdominal pressures. One patient presented with a new fascial defect 26 months post-operative.
Conclusion
Preoperative BTA to the lateral abdominal wall muscles is a safe and effective technique for the preparation of patients prior to operative management of complex ventral hernias. BTA temporary flaccid paralysis relaxes, elongates and thins the chronically contracted abdominal musculature. This in turn reduces lateral traction forces facilitating laparoscopic repair and fascial closure of large defects under minimal tension.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-017-5750-3</identifier><identifier>PMID: 28733748</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdomen ; Abdominal Muscles - diagnostic imaging ; Abdominal Muscles - drug effects ; Abdominal Surgery ; Abdominal Wall - diagnostic imaging ; Abdominal Wall - surgery ; Adult ; Aged ; Aged, 80 and over ; Botulinum toxin ; Botulinum Toxins, Type A - therapeutic use ; Defects ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Hernia, Ventral - surgery ; Hernias ; Humans ; Injections, Intramuscular ; Laparoscopy ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Muscle Contraction - drug effects ; Neuromuscular Agents - therapeutic use ; Patients ; Preoperative Care ; Proctology ; Prospective Studies ; Surgery ; Surgical Mesh ; Tomography, X-Ray Computed ; Young Adult</subject><ispartof>Surgical endoscopy, 2018-02, Vol.32 (2), p.831-839</ispartof><rights>Springer Science+Business Media, LLC 2017</rights><rights>Surgical Endoscopy is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-91da8fc6c71f59161fc3e7f4274343ca3207f0b900098e00004e79ba8e04310c3</citedby><cites>FETCH-LOGICAL-c372t-91da8fc6c71f59161fc3e7f4274343ca3207f0b900098e00004e79ba8e04310c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-017-5750-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-017-5750-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28733748$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rodriguez-Acevedo, Omar</creatorcontrib><creatorcontrib>Elstner, Kristen E.</creatorcontrib><creatorcontrib>Jacombs, Anita S. W.</creatorcontrib><creatorcontrib>Read, John W.</creatorcontrib><creatorcontrib>Martins, Rodrigo Tomazini</creatorcontrib><creatorcontrib>Arduini, Fernando</creatorcontrib><creatorcontrib>Wehrhahm, Michael</creatorcontrib><creatorcontrib>Craft, Colette</creatorcontrib><creatorcontrib>Cosman, Peter H.</creatorcontrib><creatorcontrib>Dardano, Anthony N.</creatorcontrib><creatorcontrib>Ibrahim, Nabeel</creatorcontrib><title>Preoperative Botulinum toxin A enabling defect closure and laparoscopic repair of complex ventral hernia</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Introduction
Operative management of complex ventral hernia still remains a significant challenge for surgeons. Closure of large defects in the unprepared abdomen has serious pathophysiological consequences due to chronic contraction and retraction of the lateral abdominal wall muscles. We report outcomes of 56 consecutive patients who had preoperative Botulinum toxin A (BTA) abdominal wall relaxation facilitating closure and repair.
Methods
This was a prospective observational study of 56 patients who underwent ultrasound-guided BTA into the lateral abdominal oblique muscles prior to elective ventral hernia repair between November 2012 and January 2017. Serial non-contrast abdominal CT imaging was performed to evaluate changes in lateral oblique muscle length and thickness. All hernias were repaired laparoscopically, or laparoscopic-open-laparoscopic (LOL) using intraperitoneal onlay mesh.
Results
56 patients received BTA injections at predetermined sites to the lateral oblique muscles, which were well tolerated. Mean patient age was 59.7 years, and mean BMI was 30.9 kg/m
2
(range 21.8–54.0). Maximum defect size was 24 × 27 cm. A subset of 18 patients underwent preoperative pneumoperitoneum as an adjunct procedure. A comparison of pre-BTA to post-BTA imaging demonstrated an increase in mean lateral abdominal wall length from 16.1 cm to 20.1 cm per side, a mean gain of 4.0 cm/side (range 1.0–11.7 cm/side) (
p
< 0.0001). This corresponds to an
unstretched
mean length gain of 8.0 cm of the lateral abdominal wall. Laparoscopic/LOL primary closure was achieved in all cases, with no clinical evidence of raised intra-abdominal pressures. One patient presented with a new fascial defect 26 months post-operative.
Conclusion
Preoperative BTA to the lateral abdominal wall muscles is a safe and effective technique for the preparation of patients prior to operative management of complex ventral hernias. BTA temporary flaccid paralysis relaxes, elongates and thins the chronically contracted abdominal musculature. This in turn reduces lateral traction forces facilitating laparoscopic repair and fascial closure of large defects under minimal tension.</description><subject>Abdomen</subject><subject>Abdominal Muscles - diagnostic imaging</subject><subject>Abdominal Muscles - drug effects</subject><subject>Abdominal Surgery</subject><subject>Abdominal Wall - diagnostic imaging</subject><subject>Abdominal Wall - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Botulinum toxin</subject><subject>Botulinum Toxins, Type A - therapeutic use</subject><subject>Defects</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hernia, Ventral - surgery</subject><subject>Hernias</subject><subject>Humans</subject><subject>Injections, Intramuscular</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Muscle Contraction - drug effects</subject><subject>Neuromuscular Agents - therapeutic use</subject><subject>Patients</subject><subject>Preoperative Care</subject><subject>Proctology</subject><subject>Prospective Studies</subject><subject>Surgery</subject><subject>Surgical Mesh</subject><subject>Tomography, X-Ray Computed</subject><subject>Young Adult</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kUtLAzEUhYMotlZ_gBsJuHEzmtc0k6WKLyjoQtchTW_qyEwyJjOl_ntTqiKCq4TkOyc59yB0TMk5JUReJELEVBSEyqKUJSn4DhpTwVnBGK120ZgoTgomlRihg5TeSMYVLffRiFWScymqMXp9ihA6iKavV4CvQj80tR9a3Id17fElBm_m-WSJF-DA9tg2IQ0RsPEL3JjOxJBs6GqLI3Smjjg4bEPbNbDGK_B9NA1-hehrc4j2nGkSHH2tE_Rye_N8fV_MHu8eri9nheWS9YWiC1M5O7WSulLRKXWWg3SCScEFt4YzIh2Zq5xFVUA2kUCqucl7wSmxfILOtr5dDO8DpF63dbLQNMZDGJKmirEyayXL6Okf9C0M0effZSqPbioY45miW8rmrCmC012sWxM_NCV6U4Pe1qBzDXpTg95oTr6ch3kLix_F99wzwLZAyld-CfHX0_-6fgKBRJJH</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Rodriguez-Acevedo, Omar</creator><creator>Elstner, Kristen E.</creator><creator>Jacombs, Anita S. W.</creator><creator>Read, John W.</creator><creator>Martins, Rodrigo Tomazini</creator><creator>Arduini, Fernando</creator><creator>Wehrhahm, Michael</creator><creator>Craft, Colette</creator><creator>Cosman, Peter H.</creator><creator>Dardano, Anthony N.</creator><creator>Ibrahim, Nabeel</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20180201</creationdate><title>Preoperative Botulinum toxin A enabling defect closure and laparoscopic repair of complex ventral hernia</title><author>Rodriguez-Acevedo, Omar ; Elstner, Kristen E. ; Jacombs, Anita S. W. ; Read, John W. ; Martins, Rodrigo Tomazini ; Arduini, Fernando ; Wehrhahm, Michael ; Craft, Colette ; Cosman, Peter H. ; Dardano, Anthony N. ; Ibrahim, Nabeel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-91da8fc6c71f59161fc3e7f4274343ca3207f0b900098e00004e79ba8e04310c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdomen</topic><topic>Abdominal Muscles - diagnostic imaging</topic><topic>Abdominal Muscles - drug effects</topic><topic>Abdominal Surgery</topic><topic>Abdominal Wall - diagnostic imaging</topic><topic>Abdominal Wall - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Botulinum toxin</topic><topic>Botulinum Toxins, Type A - therapeutic use</topic><topic>Defects</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hernia, Ventral - surgery</topic><topic>Hernias</topic><topic>Humans</topic><topic>Injections, Intramuscular</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Muscle Contraction - drug effects</topic><topic>Neuromuscular Agents - therapeutic use</topic><topic>Patients</topic><topic>Preoperative Care</topic><topic>Proctology</topic><topic>Prospective Studies</topic><topic>Surgery</topic><topic>Surgical Mesh</topic><topic>Tomography, X-Ray Computed</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rodriguez-Acevedo, Omar</creatorcontrib><creatorcontrib>Elstner, Kristen E.</creatorcontrib><creatorcontrib>Jacombs, Anita S. W.</creatorcontrib><creatorcontrib>Read, John W.</creatorcontrib><creatorcontrib>Martins, Rodrigo Tomazini</creatorcontrib><creatorcontrib>Arduini, Fernando</creatorcontrib><creatorcontrib>Wehrhahm, Michael</creatorcontrib><creatorcontrib>Craft, Colette</creatorcontrib><creatorcontrib>Cosman, Peter H.</creatorcontrib><creatorcontrib>Dardano, Anthony N.</creatorcontrib><creatorcontrib>Ibrahim, Nabeel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rodriguez-Acevedo, Omar</au><au>Elstner, Kristen E.</au><au>Jacombs, Anita S. W.</au><au>Read, John W.</au><au>Martins, Rodrigo Tomazini</au><au>Arduini, Fernando</au><au>Wehrhahm, Michael</au><au>Craft, Colette</au><au>Cosman, Peter H.</au><au>Dardano, Anthony N.</au><au>Ibrahim, Nabeel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative Botulinum toxin A enabling defect closure and laparoscopic repair of complex ventral hernia</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2018-02-01</date><risdate>2018</risdate><volume>32</volume><issue>2</issue><spage>831</spage><epage>839</epage><pages>831-839</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Introduction
Operative management of complex ventral hernia still remains a significant challenge for surgeons. Closure of large defects in the unprepared abdomen has serious pathophysiological consequences due to chronic contraction and retraction of the lateral abdominal wall muscles. We report outcomes of 56 consecutive patients who had preoperative Botulinum toxin A (BTA) abdominal wall relaxation facilitating closure and repair.
Methods
This was a prospective observational study of 56 patients who underwent ultrasound-guided BTA into the lateral abdominal oblique muscles prior to elective ventral hernia repair between November 2012 and January 2017. Serial non-contrast abdominal CT imaging was performed to evaluate changes in lateral oblique muscle length and thickness. All hernias were repaired laparoscopically, or laparoscopic-open-laparoscopic (LOL) using intraperitoneal onlay mesh.
Results
56 patients received BTA injections at predetermined sites to the lateral oblique muscles, which were well tolerated. Mean patient age was 59.7 years, and mean BMI was 30.9 kg/m
2
(range 21.8–54.0). Maximum defect size was 24 × 27 cm. A subset of 18 patients underwent preoperative pneumoperitoneum as an adjunct procedure. A comparison of pre-BTA to post-BTA imaging demonstrated an increase in mean lateral abdominal wall length from 16.1 cm to 20.1 cm per side, a mean gain of 4.0 cm/side (range 1.0–11.7 cm/side) (
p
< 0.0001). This corresponds to an
unstretched
mean length gain of 8.0 cm of the lateral abdominal wall. Laparoscopic/LOL primary closure was achieved in all cases, with no clinical evidence of raised intra-abdominal pressures. One patient presented with a new fascial defect 26 months post-operative.
Conclusion
Preoperative BTA to the lateral abdominal wall muscles is a safe and effective technique for the preparation of patients prior to operative management of complex ventral hernias. BTA temporary flaccid paralysis relaxes, elongates and thins the chronically contracted abdominal musculature. This in turn reduces lateral traction forces facilitating laparoscopic repair and fascial closure of large defects under minimal tension.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>28733748</pmid><doi>10.1007/s00464-017-5750-3</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0930-2794 |
| ispartof | Surgical endoscopy, 2018-02, Vol.32 (2), p.831-839 |
| issn | 0930-2794 1432-2218 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1922509872 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Abdomen Abdominal Muscles - diagnostic imaging Abdominal Muscles - drug effects Abdominal Surgery Abdominal Wall - diagnostic imaging Abdominal Wall - surgery Adult Aged Aged, 80 and over Botulinum toxin Botulinum Toxins, Type A - therapeutic use Defects Female Gastroenterology Gynecology Hepatology Hernia, Ventral - surgery Hernias Humans Injections, Intramuscular Laparoscopy Male Medicine Medicine & Public Health Middle Aged Muscle Contraction - drug effects Neuromuscular Agents - therapeutic use Patients Preoperative Care Proctology Prospective Studies Surgery Surgical Mesh Tomography, X-Ray Computed Young Adult |
| title | Preoperative Botulinum toxin A enabling defect closure and laparoscopic repair of complex ventral hernia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T08%3A37%3A13IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Preoperative%20Botulinum%20toxin%20A%20enabling%20defect%20closure%20and%20laparoscopic%20repair%20of%20complex%20ventral%20hernia&rft.jtitle=Surgical%20endoscopy&rft.au=Rodriguez-Acevedo,%20Omar&rft.date=2018-02-01&rft.volume=32&rft.issue=2&rft.spage=831&rft.epage=839&rft.pages=831-839&rft.issn=0930-2794&rft.eissn=1432-2218&rft_id=info:doi/10.1007/s00464-017-5750-3&rft_dat=%3Cproquest_cross%3E1922509872%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1993064223&rft_id=info:pmid/28733748&rfr_iscdi=true |