Botox & Stretch Technique Fixes Large Hernias in Dormagen, Germany
A novel approach combining Botox injections with targeted abdominal wall stretching is enabling successful treatment of even very large incisional hernias at the Krankenhaus Dormagen. Dr. Nicholas Bohnert, Head of the Department of General and Visceral Surgery, is the only surgeon currently utilizing this method within the Rhein-Kreis Neuss.
Understanding Incisional Hernias
Hernias, including groin and umbilical hernias, are among the most common conditions requiring visceral surgical care. Particularly challenging are large to very large incisional hernias – those with openings exceeding 10 centimeters – which often require complex surgical intervention. These frequently develop after major abdominal surgeries along previous incision sites.
“An incisional hernia can cause significant limitations in daily life, reduce physical resilience, and sometimes cause considerable pain,” explains Dr. Bohnert. “There is also the risk that internal organs can become trapped within the hernia, quickly becoming a life-threatening emergency.”
A Patient’s Journey
Nadja K. Experienced this firsthand. Following multiple bowel surgeries, she developed an incisional hernia. A necessary surgery to repair the hernia at another clinic was repeatedly postponed. For months, she relied on a supportive corset to manage her daily activities. “Without it, I couldn’t have done anything,” she describes. Despite the corset, the hernia grew, eventually causing internal organs to protrude into the gap. “Coughing was agonizing, and a normal bowel movement was extremely painful,” she says, adding that the condition also took a toll on her emotional well-being. Her physician in Düsseldorf then informed her about the innovative method being used at the Surgical Clinic in Dormagen.
The Innovative Treatment Protocol
Several weeks before Nadja K.’s surgery, Dr. Bohnert injected Botulinumtoxin (Botox) into her lateral abdominal muscles. This relaxes the muscle tissue, making it easier to close the abdominal wall. Dr. Bohnert and a working group from Hamburg first applied this technique in Germany in 2017. It has since become established for complex incisional hernias. During the procedure, a specialized device for “fascial traction” is also used to gently stretch the abdominal wall, enabling a tension-free closure.
“Both methods are effective in themselves, but the combination of both procedures delivers particularly good results,” explains Dr. Bohnert. The procedure is suitable for all patients who are fit for surgery, and anesthesia.
Post-Operative Recovery
Two weeks after Nadja K.’s surgery, Dr. Nicholas assessed the results with an ultrasound: “Everything looks very good; the abdominal muscles are where they should be,” the surgeon stated, satisfied. He then provided her with post-operative recommendations: “Move as normally as possible, get fresh air, and swimming is possible again. And eat a protein-rich diet.”
Frequently Asked Questions
What is an incisional hernia?
An incisional hernia is a bulge that develops through a previous surgical incision. They often occur after major abdominal surgeries.
What are the risks of a large incisional hernia?
Large incisional hernias can cause pain, limit physical activity, and carry the risk of internal organs becoming trapped, which can lead to a life-threatening emergency.
How does the Dormagen treatment differ from traditional hernia repair?
The Dormagen treatment combines Botox injections to relax abdominal muscles with a technique called fascial traction to gently stretch the abdominal wall, allowing for a less tense repair.
As this innovative approach gains traction, it will be interesting to see how it impacts long-term outcomes and potentially expands access to effective treatment for patients with complex incisional hernias.