OC-024 MINIMALLY INVASIVE TREATMENT OF COMPLEX INCISIONAL/VENTRAL HERNIAS USING BOTULINUM TOXIN COMBINED WITH ROBOTIC SURGERY: ROBOTOX PROTOCOL

Abstract

Abstract Introduction Incisional/ventral hernia repair has changed in the last 20 years. Posterior component separation like TAR (transversus abdominis muscle release) has increased as a revolutionary technique. On the other hand, the use of botulinum toxin (BT) has allowed better closure defect with no tension. We present a preliminary original protocol named ROBOTOX for complex incisional /ventral hernia repair that combined BT and robotic surgery to minimize the TAR procedure. Material and methods BT (Dysport®) was administered in patients with a complex incisional hernia repair and a transverse defect ≧8cm one month before robotic surgery. Demographic variables (age, sex, BMI), EHS classification, need of TAR, size transverse defect, postoperative complications and recurrence were studied. All patients had a previous CT scan. Results Five patients were included in ROBOTOX protocol, 3 men and 2 women with a median age of 63±8, median BMI of 32±3. Four patients had a M3W3 and one a L3 W2 hernia. Median size defect of 11,2±2. Three of them only needed Rives technique, one a unilateral TAR and one a 5 cm dissection of bilateral TAR. At the moment, with a FU of 6±2 months, no recurrences have been reported. Conclusions Robotic surgery combined with BT would allow a downstaging treatment in patients with complex incisional/ventral hernias. A major cases and long term follow up is needed to better conclusions.