Surgery with Botulinum Toxin a for Incisional Hernia

Inclusion Criteria: 1. Patients between 18 and 79 years; 2. BMI \< 35 kg/m²; 3. Midline anterior primary or recurrent IH (subxiphoidal to suprapubic), of width \>= 10 cm, on the abdominopelvic CT without injection of contrast agent, performed in the 6 months before inclusion (EHS W3); 4. IH without loss of domain, defined by the ratio: (volume of the peritoneal sac) / (total peritoneal volume) \< 25%, on the abdominal CT without injection of contrast agent, performed in the 6 months before inclusion; 5. Written informed consent; 6. Scheduled surgery for an open IH repair; 7. For female of childbearing potential: using highly effective contraception. Exclusion Criteria: 1. Other types of IH (lateral, groin, para-stomal, portsite); 2. VHWG grades 3 or 4 for the risk of surgical site infection; 3. Ongoing skin infection or inflammation at the IH site or at the BTA injection site; 4. Planned IH repair with slowly absorbable mesh; 5. IH with loss of domain (volumetric ratio \> 25%); 6. Emergency IH surgery; 7. ASA score \> 3; 8. Pregnancy or breastfeeding; 9. Ongoing treatment with aminoglycosides; 10. Severe hemostasis disorder or non-weaning treatment with curative dose anticoagulant; 11. Active tobacco use (or cessation inferior to 3 months); 12. Use of another investigational product within 6 months or 5 half-lives (whichever is longer), or currently participating in a prospective study with an investigational product, whether it concerns an experimental drug or a medical device; 13. Patient not covered by social insurance; 14. Patient under legal guardianship; 15. Hypersensitivity to the active substance (Clostridium Botulinum neurotoxin type A) or to any of the excipients (Human albumin, sucrose); 16. Generalized disorders of muscle activity (e.g. myasthenia gravis, Lambert-Eaton syndrome, peripheral motor neuropathic diseases (e.g. amyotrophic lateral sclerosis or motor neuropathy), facial nerve disorders, underlying neurological disorders) and history of dysphagia and aspiration); 17. Patient with ongoing treatment with medicinal products that interfere with the transfer of an impulse from a nerve to a muscle, e.g. tubocurarine-type muscle relaxants that weaken the muscles; 18. Patient with severe and uncontrolled cardiovascular diseases; 19. Patient has received BTA within 12 weeks; 20. Patients with a history of seizures.