Sergio E. López-Juárez, Department of General Surgery, Hospital Regional Madero PEMEX, Ciudad Madero, Tamps., Mexico
Alberto Medina-Benítez, Department of General Surgery, Hospital Regional Madero PEMEX, Ciudad Madero, Tamps., Mexico
Ricardo Durán-Reyes, Department of General Surgery, Hospital Regional Madero PEMEX, Ciudad Madero, Tamps., Mexico
Bernardo I. Bagundo-Pérez, Department of Radiology and Imaging, Hospital Regional Madero PEMEX, Ciudad Madero, Tamps., Mexico
Oscar I. Fortuna-Sandoval, Department of Maxillofacial Surgery, Hospital Regional Madero PEMEX, Ciudad Madero, Tamps., Mexico
Mariana S. Trejo-García, Faculty of Medicine, Instituto de Ciencias y Estudios Superiores de Tamaulipas, Tampico. Tamps., Mexico

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.

Keywords: Ventral Hernia. Pneumoperitoneum. Botulinum toxin A. IncobotulinumtoxinA.