TY - JOUR
T1 - Abdominal wall reconstruction in abdominal wall endometriosis
T2 - A case report and literature review
AU - van Varsseveld, Otis C.
AU - Koeijers, Gustavo G.
AU - Vitoria, Juan M.Rodriguez
AU - Bravio, Igor Gomes
N1 - Publisher Copyright:
© 2023 Georg Thieme Verlag. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Abdominal wall endometriosis (AWE) is a rare condition representing 1% of patients operated for endometriosis. We describe a case of a 26-year-old woman, with a history of cesarean delivery, who presented with cyclical pain and a subcutaneous mass in the lower abdomen. Where most AWE lesions may be surgically managed by a single surgeon, imaging revealed an unusually large lesion (13x4x10cm) involving the rectus abdominis muscle. Plastic, gynecologic and general surgeons combined their expertise to conduct AWE excision combined with mini-Abdominoplasty in a single procedure. After resection, a retrorectus mesh (Rives-Stoppa technique) reinforced the primarily closed posterior rectus sheath and an inlay mesh bridged the defect left in the anterior rectus sheath. The patient was discharged three days postoperatively, had minimal pain complaints and was satisfied with cosmetic results at one-month follow up. One year postoperatively, she gave uncomplicated vaginal birth. We conclude that, in select cases, management of a large, symptomatic AWE may benefit from a multidisciplinary approach, where symptom relief and an aesthetically pleasing result for the patient can be achieved in a single procedure. We distinctively describe double mesh repair as a viable consideration for reconstruction in AWE and review current considerations in mesh repair of the abdominal wall. Further studies into this topic are warranted.
AB - Abdominal wall endometriosis (AWE) is a rare condition representing 1% of patients operated for endometriosis. We describe a case of a 26-year-old woman, with a history of cesarean delivery, who presented with cyclical pain and a subcutaneous mass in the lower abdomen. Where most AWE lesions may be surgically managed by a single surgeon, imaging revealed an unusually large lesion (13x4x10cm) involving the rectus abdominis muscle. Plastic, gynecologic and general surgeons combined their expertise to conduct AWE excision combined with mini-Abdominoplasty in a single procedure. After resection, a retrorectus mesh (Rives-Stoppa technique) reinforced the primarily closed posterior rectus sheath and an inlay mesh bridged the defect left in the anterior rectus sheath. The patient was discharged three days postoperatively, had minimal pain complaints and was satisfied with cosmetic results at one-month follow up. One year postoperatively, she gave uncomplicated vaginal birth. We conclude that, in select cases, management of a large, symptomatic AWE may benefit from a multidisciplinary approach, where symptom relief and an aesthetically pleasing result for the patient can be achieved in a single procedure. We distinctively describe double mesh repair as a viable consideration for reconstruction in AWE and review current considerations in mesh repair of the abdominal wall. Further studies into this topic are warranted.
KW - Abdominal wall
KW - Abdominoplasty
KW - Endometriosis
KW - Plastic
KW - Surgery
KW - Surgical mesh
UR - http://www.scopus.com/inward/record.url?scp=85195166519&partnerID=8YFLogxK
U2 - 10.1055/a-2336-0073
DO - 10.1055/a-2336-0073
M3 - Article
AN - SCOPUS:85195166519
SN - 2234-6163
JO - Archives of Plastic Surgery
JF - Archives of Plastic Surgery
ER -