“Toxina botulínica A y neumoperitoneo progresivo en el manejo quirúrgico de las hernias incisionales gigantes”

Abstract

Introduction: Incisional hernias are protrusions at the site of post-surgical incisions, either midline or lateral. They are classified according to their dimension into small, medium, and giant hernias. Giant hernias depend on their size (greater than 15cm) and characteristics. There are several management procedures, however: there are two techniques on the rise, Botulinum Toxin A and Progressive Pneumoperitoneum, which can be employed independently or combined, providing good results at the usage time for adequate closure of the hernia reducing post-operative complications. Objective: To determine the effectiveness of giant incisional hernia management utilizing Botulinum Toxin and Progressive Pneumoperitoneum versus the traditional method. Method: Qualitative and descriptive study based on the PRISMA 2020 statement. Type: Bibliographic review of databases and scientific journals that collect impact information on giant incisional hernias and their preoperative management through Botulinum Toxin A and Progressive Pneumoperitoneum usage. Results and conclusions: The analysis of high-impact articles shows that using Botulinum Toxin A helps to elongate the aponeurotic edges and facilitates muscle approximation paralysis. Progressive Pneumoperitoneum increases the volume of the abdominal cavity, improving the content-continent relationship, thus ensuring adequate cavity closure with a low risk of complications.