CC BY 4.0 · Arch Plast Surg
DOI: 10.1055/a-2336-0073
Case Report

Abdominal Wall Reconstruction in Abdominal Wall Endometriosis: A Case Report and Literature Review

Otis C. van Varsseveld
1   Department of Surgery, University Medical Centre Groningen, Groningen, Netherlands (Ringgold ID: RIN10173)
2   Department of Plastic, Reconstructive and Hand Surgery, Curaçao Medical Center, Willemstad, Curaçao
Gustavo G. Koeijers
2   Department of Plastic, Reconstructive and Hand Surgery, Curaçao Medical Center, Willemstad, Curaçao
Juan M. Rodriguez Vitoria
3   Department of Surgery, Curaçao Medical Center, Willemstad, Curaçao
Igor Gomes Bravio
4   Department of Obstetrics & Gynecology, Curaçao Medical Center, Willemstad, Curaçao
› Author Affiliations
Supported by: Universitair Medisch Centrum Groningen

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.

Publication History

Received: 13 July 2023

Accepted after revision: 28 May 2024

Accepted Manuscript online:
30 May 2024

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