Application of botulinum toxin as a method to reduce the scope of component separation hernioplasty in postoperative ventral hernia repair

Introduction. TAR hernioplasty (TAR – Transversus Abdominis Muscle Release), as a type of component separation technique, is a standard method for reconstructing the anterior abdominal wall in the treatment of large ventral hernias. However, this method is associated with significant tissue trauma, risk of complications, and a prolonged recovery period. In recent years, the possibility of preoperative botulinum toxin type A (BTA) administration has been explored to reduce the extent of component separation due to BTA's muscle-relaxing effect. The purpose of the study. Demonstration of the potential use of botulinum toxin type A (BTA) to reduce the extent of TAR hernioplasty in patients with large postoperative ventral hernias (PVH) who were initially scheduled for standard bilateral TAR hernioplasty. Materials and methods. The article describes a clinical case of treating a patient diagnosed with a postoperative ventral hernia (PVH) classified as M1-4W3R1. The preoperative preparation included the administration of botulinum toxin type A (BTA). Results. The results showed that preoperative use of BTA allowed reduction of the surgical procedure to unilateral TAR hernioplasty in a patient who was initially scheduled for bilateral TAR hernioplasty. Conclusion. Preoperative use of botulinum toxin type A (BTA) in patients with large and giant ventral hernias reduces the extent of TAR hernioplasty required.