{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T05:23:58Z","timestamp":1794201838193,"version":"4.8.0"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":165,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Asian J Endoscop Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>We have developed a stapler repair technique as an endoscopic retromuscular strategy for ventral hernia repair. Because transversus abdominis release before stapled fascial closure is technically difficult in this technique, preoperative reduction of fascial tension may be valuable even in moderate\u2010sized hernias. Botulinum toxin A may address this limitation, but its necessity and appropriate dosing in Asian patients remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, single\u2010center study included 10 patients with midline ventral hernias \u2265\u20095\u2009cm in width. Ultrasound\u2010guided botulinum toxin A was injected into the bilateral lateral abdominal wall muscles using a weight\u2010adjusted dose of 200\u2009units of Botox Vista for patients weighing \u2265\u200950\u2009kg and 100\u2009units for those weighing &lt;\u200950\u2009kg. Surgery was scheduled 4\u2009weeks later, and endoscopic retromuscular repair using the stapler repair technique was the preferred approach. CT\u2010based changes in defect width and muscle length, surgical outcomes, and treatment\u2010related adverse events were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight patients underwent endoscopic repair, one open repair, and one intraperitoneal onlay mesh plus repair. Median defect width decreased from 5.7 to 4.5\u2009cm (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), and lateral abdominal wall muscles significantly elongated bilaterally. No treatment\u2010related adverse events occurred. Primary fascial closure was achieved in all patients, with no recurrence during a median follow\u2010up of 12\u2009months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Weight\u2010adjusted preoperative botulinum toxin A was safe and produced favorable CT\u2010based morphological changes. These changes may reduce fascial tension before stapled closure and help expand the applicability of the stapler repair technique to selected patients with moderate\u2010sized ventral hernias.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ases.70323","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:01:57Z","timestamp":1781582517000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative Botulinum Toxin\n                    <scp>A<\/scp>\n                    Within an Endoscopic Retromuscular Strategy for Ventral Hernia Repair: A Preliminary Prospective Study in\n                    <scp>J<\/scp>\n                    apanese Patients"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-8993","authenticated-orcid":false,"given":"Kentaro","family":"Shinohara","sequence":"first","affiliation":[{"name":"Division of Gastroenterological Surgery, Department of Surgery Aichi Medical University  Nagakute Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7860-9209","authenticated-orcid":false,"given":"Takuya","family":"Saito","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological Surgery, Department of Surgery Aichi Medical University  Nagakute Japan"},{"name":"Department of Upper Gastrointestinal Surgery Kansai Medical University Medical Center  Moriguchi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Yasui","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological Surgery, Department of Surgery Aichi Medical University  Nagakute Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sho","family":"Ueda","sequence":"additional","affiliation":[{"name":"Division of Gastroenterological Surgery, Department of Surgery Aichi Medical University  Nagakute 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