scholarly journals Bilateral giant inguinoscrotal hernia. Presentation of a novel combined two-stage repair approach

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Charalambos Menenakos ◽  
Hendrik C Albrecht ◽  
Stephan Gretschel
Keyword(s):  
Botulinum Toxin Type A ◽  
Combined Treatment ◽  
Botulinum Toxin Type ◽  
Standing Position ◽  
Single Shot ◽  
Two Stage ◽  
Inguinoscrotal Hernia ◽  
Giant Inguinoscrotal Hernia ◽  
Life Threatening ◽  
Preoperative Progressive Pneumoperitoneum

Abstract Giant inguinoscrotal hernia is typically defined as hernia extending below the midpoint of the inner thigh, in the standing position. These hernias can be a demanding surgical problem as replacing bowel contents into the abdomen that can cause a life-threatening increase in intra-abdominal pressures. Various techniques such as preoperative progressive pneumoperitoneum (PPP), debulking of abdominal contents with visceral resections with or without omentectomy and phrenectomy have been suggested. We report the case of a 65-year-old patient with giant bilateral inguinal hernia. We applied a novel two-stage combined approach consisting of PPP with simultaneous single shot injection of botulinum toxin Type A into the anterior abdominal wall, and a second stage laparotomy with hernia repair (Stoppa technique). This technique makes possible the successful treatment of giant inguinal hernias without the need for visceral resection. To our knowledge, this is the first presented case of this combined treatment modality.

Combined Treatment Fkt-Botulinum Toxin Type A (Btx-A) in Patients with Strumpell-Lorrain Disease

2016 ◽  
Vol 22 (6) ◽  
pp. 758-763 ◽  
Author(s):  
Marvulli Riccardo ◽  
Lopopolo Angela ◽  
Dantone Angela ◽  
Palmisano Vita ◽  
Lancioni Giulio ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Combined Treatment ◽  
Type A ◽  
Botulinum Toxin Type

Pain and Muscles Properties Modifications After Botulinum Toxin Type A (BTX-A) and Radial Extracorporeal Shock Wave (rESWT) Combined Treatment

2019 ◽  
Vol 19 (8) ◽  
pp. 1127-1133 ◽  
Author(s):  
Megna Marisa ◽  
Marvulli Riccardo ◽  
Farì Giacomo ◽  
Gallo Giulia ◽  
Dicuonzo Franca ◽  
...  
Keyword(s):  
Shock Wave ◽  
Botulinum Toxin ◽  
Botulinum Toxin Injection ◽  
Botulinum Toxin Type A ◽  
Combined Treatment ◽  
Extracorporeal Shock Wave Therapy ◽  
Botulinum Toxin Type ◽  
Post Stroke ◽  
Extracorporeal Shock Wave ◽  
Group B

Background and Objective:Spasticity (most common disability in upper motor neuron syndrome or UMNS) caused an inability of patients’ to perform daily activities and a decrease inquality of life. One of the promising methods nowadays, but still not widely used in everyday practice, for spasticity reduction is extracorporeal shock wave. The aim of this study was to evaluate the objective clinical effects of combined treatment botulinum toxin type A and radial Extracorporeal Shock Wave Therapy in spasticity post stroke.Methods:We considered 30 subjects (14 female and 16 male) with post stroke spasticity of Biceps Brachii, Superficial Flexor Digitorum, Gastrocnemius Medialis and Lateralis and we divided patients into two groups (group A received botulinum toxin injection and physiotherapy while group B received botulinum toxin injection, rESWT and physiotherapy). Assessments were performed before treatment (t0), after 1 (t1), 2 (t2) e 3 (t3) months using Modified Ahworth Scale, Visual Analogical Scale for pain and MyotonPro® device (to assessed myometric evaluation of muscles tone and stiffness).Results:Visual Analogical Scale, Modified Ahworth Scale, muscles tone and stiffness statistically decreased until t3 in the group A and in the group B, but the differences between the two groups were significant at the t1 only.Conclusion:Radial Extracorporeal Shock Wave Therapy could be an effective physical treatment aimed at the reduction of upper and lower limbs spasticity and could lead to the improvement of trophic conditions of the spastic muscles in post-stroke.

scholarly journals Improvement and Neuroplasticity after Combined Rehabilitation to Forced Grasping

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Michiko Arima ◽  
Atsuko Ogata ◽  
Kazumi Kawahira ◽  
Megumi Shimodozono
Keyword(s):  
Electrical Stimulation ◽  
Upper Limb ◽  
Near Infrared ◽  
Botulinum Toxin Type A ◽  
Combined Treatment ◽  
Neuromuscular Electrical Stimulation ◽  
Botulinum Toxin Type ◽  
Functional Improvement ◽  
Upper Limb Function ◽  
Flexor Muscles

The grasp reflex is a distressing symptom but the need to treat or suppress it has rarely been discussed in the literature. We report the case of a 17-year-old man who had suffered cerebral infarction of the right putamen and temporal lobe 10 years previously. Forced grasping of the hemiparetic left upper limb was improved after a unique combined treatment. Botulinum toxin type A (BTX-A) was first injected into the left biceps, wrist flexor muscles, and finger flexor muscles. Forced grasping was reduced along with spasticity of the upper limb. In addition, repetitive facilitative exercise and object-related training were performed under low-amplitude continuous neuromuscular electrical stimulation. Since this 2-week treatment improved upper limb function, we compared brain activities, as measured by near-infrared spectroscopy during finger pinching, before and after the combined treatment. Brain activities in the ipsilesional sensorimotor cortex (SMC) and medial frontal cortex (MFC) during pinching under electrical stimulation after treatment were greater than those before. The results suggest that training under electrical stimulation after BTX-A treatment may modulate the activities of the ipsilesional SMC and MFC and lead to functional improvement of the affected upper limb with forced grasping.

scholarly journals Successful outcome of a giant inguinoscrotal hernia: a novel two-staged repair using preoperative progressive pneumoperitoneum and transversus abdominis release

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Derek B Miller ◽  
Logan Reed
Keyword(s):  
Rural Areas ◽  
Perioperative Complications ◽  
Developed Countries ◽  
Transversus Abdominis ◽  
Successful Outcome ◽  
Transversus Abdominis Release ◽  
Inguinoscrotal Hernia ◽  
Abdominal Hypertension ◽  
Giant Inguinoscrotal Hernia ◽  
Preoperative Progressive Pneumoperitoneum

Abstract Giant inguinoscrotal hernias, defined as the extension beyond the midpoint of the inner thigh, continue to require multi-step approaches due to their complexity. Although rare in developed countries, they are commonly present in rural areas after years of neglect. This consequently allows the abdomen to maladapt to lower volumes, creating a loss of domain. Here, we present a giant left inguinoscrotal hernia managed with a unique multi-stage approach, aimed to minimize commonly encountered perioperative complications associated with abdominal hypertension. The combined two-staged approach used begins with preoperative progressive pneumoperitoneum, followed by the combined procedures of laparotomy hernia repair (Stoppa technique) and transversus abdominis release, thereby promoting a tension-free closure that is able to accommodate the reduced contents. Various modalities used in treating these hernias have been previously described; however, to our knowledge, the combined use of techniques described here has not been reported.

Preoperative progressive pneumoperitoneum and botulinum toxin type A in patients with large incisional hernia

Hernia ◽  
2017 ◽  
Vol 21 (2) ◽  
pp. 233-243 ◽  
Author(s):  
J. Bueno-Lledó ◽  
A. Torregrosa ◽  
N. Ballester ◽  
O. Carreño ◽  
F. Carbonell ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Incisional Hernia ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Large Incisional Hernia ◽  
Preoperative Progressive Pneumoperitoneum

Botulinum toxin type A (incobotulinumtoxinA) in cerebral palsy: Combined treatment of spasticity and sialorrhea

Toxicon ◽  
2021 ◽  
Vol 190 ◽  
pp. S44
Author(s):  
Alexey Kurenkov ◽  
Olga Klochkova ◽  
Lydmila Kuzenkova ◽  
Bella Bursagova ◽  
Ulvija Ashrafova
Keyword(s):  
Cerebral Palsy ◽  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Combined Treatment ◽  
Type A ◽  
Botulinum Toxin Type

scholarly journals Giant Inguinoscrotal Hernia—Report of a Rare Case With Literature Review

2014 ◽  
Vol 99 (5) ◽  
pp. 560-564 ◽  
Author(s):  
Vilvapathy Senguttuvan Karthikeyan ◽  
Sarath Chandra Sistla ◽  
Duvuru Ram ◽  
Sheik Manwar Ali ◽  
Nagarajan Rajkumar
Keyword(s):  
Inguinal Hernia ◽  
Small Bowel ◽  
Rare Case ◽  
Standing Position ◽  
Greater Omentum ◽  
Review Of The Literature ◽  
Inguinoscrotal Hernia ◽  
Giant Inguinoscrotal Hernia ◽  
Respiratory Exercises ◽  
Simple Reduction

Abstract Massive inguinoscrotal hernias extending below the midpoint of the inner thigh, in the standing position constitute giant inguinoscrotal hernias. We report a patient who presented with giant right inguinal hernia with bilateral hydrocele for 25 years. He had no cardiorespiratory illnesses. He was taken up for surgery under general anesthesia after preoperative respiratory exercises. Sliding hernia with entire greater omentum, small bowel, and appendix as contents was identified. Meshplasty after omentectomy with bilateral subtotal excision of sac, right orchidectomy, and scrotoplasty were done. Giant inguinoscrotal hernias pose significant problems while replacing bowel contents because of the increase in intraabdominal and intrathoracic pressures. Recurrence is another complication seen after successful surgical management. Various techniques such as preoperative pneumoperitoneum, debulking abdominal contents with extensive bowel resections, or omentectomy and phrenectomy have been tried. Postoperative elective ventilation is also needed in many cases. We describe simple reduction with omentectomy as a viable technique in this patient. He did not need elective ventilation due to preoperative respiratory exercises and preparation and review of the literature.

scholarly journals Complex Incisional Hernia – Easy To Diagnose But What To Do After?

2021 ◽  
pp. 254
Author(s):  
Keyword(s):  
Botulinum Toxin ◽  
Abdominal Wall ◽  
Rapid Development ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Fascial Closure ◽  
Loss Of Domain ◽  
Umbilical Hernia Repair ◽  
Preoperative Progressive Pneumoperitoneum

Introduction. Loss of domain represents a defect in abdominal wall or loss of continuity of fascial closure, with more than 20% of the peritoneal cavity content under the skin in a serous sac, where the reconstruction involves additional reconstructive techniques. Clinical Case. A 63-year-old active smoker with multiple comorbidities such as COPD severe form with the need for oxygen at home (may be an absolute contraindication) and surgical history of open umbilical hernia repair with a rapid development of loss of domain hernia (2 weeks after surgery) was prepared preoperatively with Botulinum Toxin type A and Preoperative Progressive Pneumoperitoneum. Discussion. Despite comorbidities, by optimizing the abdominal wall with Botulinum Toxin type A and Preoperative Progressive Pneumoperitoneum with the intraoperative use of the Rives-Stoppa technique or posterior separation of components, Abdominal Wall Strength Score improves significantly in a short time, with quick socio-economic reintegration and low-rate of complications. Conclusions. By preoperative preparation, with augmentation techniques of the abdominal wall, thus, even the barriers given by comorbidities (absolute contraindications) are overcame, with low postoperative risks, offering the patient a normal quality of life.

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