# Case series: oncologic patients in remission with giant ventral hernia treated with botulinum toxin and component separation

## TL;DR

This paper reports successful hernia repairs in cancer survivors using botulinum toxin and a special surgical technique.

## Contribution

The study introduces botulinum toxin as a safe and effective aid for complex hernia repair in oncologic patients.

## Key findings

- Four oncologic patients in remission had successful hernia repairs using botulinum toxin and component separation.
- The technique enabled tension-free closure without complications or early recurrence.
- Botulinum toxin reduced the need for invasive procedures and improved postoperative outcomes.

## Abstract

Giant ventral hernia represents a surgical challenge, particularly in oncologic patients in remission, due to large fascial defects and loss of domain. Botulinum toxin has been incorporated as an adjuvant to facilitate fascial closure through chemical relaxation of the abdominal wall. We describe four oncologic patients in remission with giant ventral hernia treated with preoperative botulinum toxin and repair using component separation with retromuscular polypropylene mesh placement. The procedures were performed without intraoperative complications or early recurrence. The technique allowed tension-free fascial closure with favorable postoperative outcomes. Botulinum toxin appears to be a useful and safe tool for the repair of complex ventral hernias in oncologic patients in remission, promoting fascial approximation and reducing the need for more invasive procedures.