Synchronous Surgical Treatment of Morbid Obesity and Complex Ventral Hernia After Progressive Pneumoperitoneum and Botulinum Toxin A Injection

نویسندگان

چکیده

The worldwide increase in morbidly obese patients with complex hernia raises controversies the choice of appropriate treatment timing: synchronous bariatric and abdominal wall surgery versus delayed surgery. We report an innovative tailored surgical carried out at our Institution. approach provided injection, 6 weeks before surgery, 500 IU botulinum toxin A on either side large muscles. Four pneumoperitoneum was inducted out-patient daily sessions progressive insufflation ambient air were then out. Surgery scheduled 48 days after injection. Sleeve gastrectomy simultaneous posterior component separation transversus abdominis release performed. Two prosthetic meshes placed sublay. Postoperative superficial site infection successfully treated negative pressure wound therapy. At a 1-year follow-up, no recurrence recorded while total body weight loss 31%. delay ventral repair could worsen quality life patients. In such high-risk patients, best strategy remains controversial. There is great concern performing simultaneously to repair, although there lack evidence which ideal modality. Synchronous should be approached high-volume centres where consolidated experience multidisciplinary teamwork available. Combined preoperative administration allow for safe resolution domain.

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ژورنال

عنوان ژورنال: Indian Journal of Surgery

سال: 2021

ISSN: ['0973-9793', '0972-2068']

DOI: https://doi.org/10.1007/s12262-021-02764-8