IRCT20230408057846N1 IRCT 2023-06-18 Mashhad University of Medical Sciences Administration of pneumoperitoneum and botulinum toxin in abdominal wall reconstruction Safety and effectiveness of preoperative progressive pneumoperitoneum and botulinum toxin administration before abdominal wall reconstruction in patients with complex ventral hernia with loss of domain. 2023-04-21 anticipated 10 Complete https://irct.ir/trial/69496 interventional Randomization: N/A, Blinding: Not blinded, Placebo: Not used, Assignment: Single, Purpose: Treatment. 2 Large abdominal wall hernia with loss of domain. Intervention group: 500 units of botulinum A (Masport, MasoonDarou Pharmaceutical Company, Iran) are mixed in 50 ml of normal saline. Under ultrasound guidance, it is injected in three layers of internal, external, and transverse oblique muscle in the abdominal wall and in 10 areas. The patient will be subjected to prep and drape in the same session for pneumoperitoneum. A small incision is made 5 cm from the herniated area, then the abdominal wall muscles are opened. Then, an 8-French feeding tube catheter is inserted into the peritoneum. Then the small incision is repaired, and the catheter is sutured to the abdominal wall. Finally, air injection starts in the amount of 1000 to 1500 ml in the first day. In the following days, the amount of air injection will be increased or decreased to such an extent that it does not cause discomfort, pain, or shortness of breath. The procedure will be performed in one session. After 1 month, the abdominal cavity and incisional hernia volume will be measured.. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is There is no further information