Use of botulinum toxin type A in the prehabilitation of abdominal wall musculature for hernia repair: a consensus proposal

Salvador Pous-Serrano; José Bueno-Lledó; Providencia García-Pastor; Omar Carreño-Sáenz; Victoria Pareja-Ibars; Santiago Bonafé-Diana; Alba Maria Gea-Moreno; Jesús Martínez-Hoed; members of the Section of Abdominal Wall of the Spanish Association of Surgeons

doi:10.1016/j.cireng.2023.12.003

Use of botulinum toxin type A in the prehabilitation of abdominal wall musculature for hernia repair: a consensus proposal

Cir Esp (Engl Ed). 2024 Feb 9:S2173-5077(24)00046-2. doi: 10.1016/j.cireng.2023.12.003. Online ahead of print.

Authors

Salvador Pous-Serrano¹, José Bueno-Lledó², Providencia García-Pastor², Omar Carreño-Sáenz², Victoria Pareja-Ibars², Santiago Bonafé-Diana², Alba Maria Gea-Moreno², Jesús Martínez-Hoed³; members of the Section of Abdominal Wall of the Spanish Association of Surgeons

Collaborators

members of the Section of Abdominal Wall of the Spanish Association of Surgeons:
José Antonio Pereira Rodríguez, Julio Gómez Menchero, Salvador Pous Serrano, Luis Tallón Aguilar, Carles Olona Casas, Alberto López Farias, Antonio Ríos Zambudio, Belén Porrero Guerrero, Monserrat Juvany Gómez, Jacobo Trébol López, Manuel López Cano, Pilar Hernández Granados

Affiliations

¹ Unidad de Cirugía de Pared y Corta Estancia, Hospital Universitario y Politécnico La Fe, Valencia, España. Electronic address: pous_sal@gva.es.
² Unidad de Cirugía de Pared y Corta Estancia, Hospital Universitario y Politécnico La Fe, Valencia, España.
³ Grupo Integrado de Trabajo en Hernia Compleja, Servicio de Cirugía General, Hospital R. A. Calderón Guardia, San José, Costa Rica.

PMID: 38342140
DOI: 10.1016/j.cireng.2023.12.003

Abstract

The prehabilitation of the abdominal wall through the infiltration of botulinum toxin type A, which induces temporary chemical denervation ("chemical component separation") in the lateral abdominal musculature, is a common practice in units specialized in abdominal wall surgery. However, its use for this indication is currently off-label. The main objective of this article is to describe a consensus proposal regarding indications, contraindications, dosages employed, potential side effects, administration method, and measurement of possible outcomes. Additionally, a proposal for an informed consent document endorsed by the Abdominal Wall Section of the Spanish Association of Surgeons is attached.

Keywords: Botulinum toxin; Complex ventral hernia repair; Hernia con pérdida de domicilio; Hernia incisional; Hernia ventral; Incisional hernia; Loss of domain hernia; Prehabilitación; Prehabilitation; Reparación de hernia ventral compleja; Toxina botulínica; Ventral hernia.