Preoperative Optimization in Complex Ventral Hernia, Case Report in A Secondary Care Unit

An incisional hernia is a common complication following abdominal surgery. Some hernias gradually develop into large incisional hernias or complex ventral hernias, making repair more difficult. Complex abdominal wall defects represent one of the more challenging dilemmas faced by general surgeons. We report te case of a 42 year-old mexican male with history of abdominal trauma secondary to a firearm which required an exploratory laparotomy a year ago, with subsequent appearance of a complex ventral hernia of 10.6 cm wide and 24.5 cm long. The patient received preoperative preparation with botulinum toxin type A and progressive pneumoperitoneum and underwent a ventral plasty with tranversus abdominal release (TAR). The posoperative course was unevenful and the patient was referred for clinical surveillance. This case was successfully resolved in a secondary care unit using materials available in our hospital.