{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T05:09:15Z","timestamp":1773464955271,"version":"3.50.1"},"reference-count":23,"publisher":"Index Copernicus","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pol Przegl Chir"],"published-print":{"date-parts":[[2025,10,7]]},"abstract":"<ns3:p>&lt;b&gt;Introduction:&lt;\/b&gt; Botulinum toxin type A (BTA) has emerged as a preoperative adjunct in complex ventral hernia repair, particularly in cases with loss of domain (LOD), yet volumetric evidence of its effect on abdominal wall geometry remains scarce.&lt;b&gt;Aim:&lt;\/b&gt; To evaluate the impact of BTA on abdominal cavity expansion and lateral muscle elongation in a patient with extreme LOD using volumetric computed tomography (CT) and geometric modeling.&lt;b&gt;Materials and methods:&lt;\/b&gt; A 61-year-old male with a giant left scrotal hernia and LOD (Tanaka index &gt;25%) underwent BTA injections into the lateral abdominal wall, followed by CT imaging pre- and post-treatment. 3D reconstructions were generated to assess intra-abdominal volume and muscle lengths at three anatomical levels.&lt;b&gt;Results:&lt;\/b&gt; Abdominal cavity volume increased by 28.1% (13.74 L to 17.61 L), allowing safe visceral reintegration without abdominal compartment syndrome. The transversus abdominis exhibited the most pronounced elongation and volume gain (up to 329% elongation, 62% volume increase), while the external and internal obliques showed elongation with concurrent volume loss. The least elongation occurred at the costal level, highlighting anatomical rigidity in this region.&lt;b&gt;Discussion:&lt;\/b&gt; The results confirm that BTA-induced elongation varies by muscle and anatomical location. Minimal elongation at the subcostal level aligns with the known difficulty in closing M1-type hernias due to restricted superior abdominal wall mobility.&lt;b&gt;Conclusions:&lt;\/b&gt; BTA facilitated fascial closure by altering abdominal wall mechanics and increasing the intra-abdominal domain.&lt;b&gt;Significance:&lt;\/b&gt; This study is the first to combine volumetric and geometric modeling to objectively quantify BTA\u2019s mechanical impact, offering new insights into patient selection and planning for hernia repair with LOD.<\/ns3:p>","DOI":"10.5604\/01.3001.0055.3078","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T10:56:24Z","timestamp":1767092184000},"page":"1-8","source":"Crossref","is-referenced-by-count":1,"title":["Preoperative Botulinum Toxin A Injection in the Management of Giant Scrotal Hernia with Loss of Domain: A Volumetric and Clinical Case Study"],"prefix":"10.5604","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9847-4188","authenticated-orcid":false,"given":"Mateusz","family":"Zamkowski","sequence":"first","affiliation":[{"name":"Department of Radiology, Medical University of Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Szepietowska","sequence":"additional","affiliation":[{"name":"Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zuzanna","family":"Iwicka","sequence":"additional","affiliation":[{"name":"Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandra","family":"Kondrusik","sequence":"additional","affiliation":[{"name":"Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wiktoria","family":"Korbut","sequence":"additional","affiliation":[{"name":"Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4796-0136","authenticated-orcid":false,"given":"Micha\u0142","family":"Putko","sequence":"additional","affiliation":[{"name":"Hernia Treatment Center, LUXMED Hospital Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej","family":"\u015amieta\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3689","reference":[{"key":"632139r1","doi-asserted-by":"crossref","unstructured":"Ibarra-Hurtado T.R., Nu\u00f1o-Guzm\u00e1n C.M., Echeagaray-Herrera J.E., Robles-V\u00e9lez E., De Jes\u00fas Gonz\u00e1lez-Jaime J.: Use of botulinum toxin type a beforeabdominal wall hernia reconstruction. 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