Botulinum toxin A (IncobotulinumtoxinA) and pneumoperitoneum image-guided for hernia repair with loss of dominance

Post-incisional ventral hernia is estimated at 5-30%, when the content of the abdominal cavity migrates to the hernial sac (HSV), with a HSV/abdominal cavity volume ratio > 25%, conditioning systemic changes defined as "loss of domain".A 27-yearold male presented with ventral hernia with loss of domain that required pre-operative preparation techniques, using application of botulinum toxin A (IncobotulinumtoxinA) and pneumoperitoneum, both guided by image.A ventral plasty was performed with adequate return of the viscera to the abdominal cavity.The combination of both techniques seems to be a safe procedure to carry out a tension-free repair.