Status:

RECRUITING

Preoperative BOTOX® Injection for Large Ventral Hernia Repair

Lead Sponsor:

The Cleveland Clinic

Collaborating Sponsors:

Joseph and Florence Mandel Family Foundation

Conditions:

Hernia Abdominal Wall

Botox Injection

Eligibility:

All Genders

18+ years

Phase:

PHASE4

Brief Summary

This study is for adults who need open surgery to repair a very large abdominal (ventral) hernia. This study tests whether a one-time, image-guided injection of a medicine commonly known as "BOTOX®" (...

Detailed Description

Background and Rationale: Massive ventral hernias (pre-op axial width ≥15 cm and/or Tanaka volume ratio \>25%) seldom achieve primary fascial closure (PFC) and are associated with higher respiratory ...

Eligibility Criteria

Inclusion

  • Adult (greater than or equal to 18 years of age)
  • Candidate for elective open repair of ventral hernia
  • Preoperative imaging demonstrating either:
  • ventral hernia defect width of at lest 15 cm; AND/OR,
  • Tanaka volume ratio of at least 25%
  • Planned elective hernia repair in an open fashion via a midline laparotomy with posterior component separation and transversus abdominis release

Exclusion

  • Emergent cases
  • Pregnancy and/or breastfeeding at time of intramuscular injection
  • Inability to provide informed consent
  • Inability to receive either study intervention (i.e. allergy to local anesthetics utilized for intervention administration, allergy and/or contraindication to any botulinum toxin, inability to attend outpatient administration of study intervention, inability to conform to safety check schedule)
  • Known congenital or acquired neuromuscular disorder
  • Presence of stoma
  • Current infection at time of intramuscular injection
  • Flank hernias s defined by EHS L1-L4
  • BMI \> 45 kg/m\^2
  • Diaphragmatic hemiparesis or chronic obstructive pulmonary disease (COPD) with chronic oxygen dependence

Key Trial Info

Start Date :

November 3 2025

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

December 15 2029

Estimated Enrollment :

188 Patients enrolled

Trial Details

Trial ID

NCT07220382

Start Date

November 3 2025

End Date

December 15 2029

Last Update

November 21 2025

Active Locations (1)

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1

Cleveland Clinic Main Campus

Cleveland, Ohio, United States, 44195