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by gemini-2.5-flash-lite, 2026-06-08
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This paper reviews perioperative considerations for abdominal wall endometriosis, focusing on diagnosis, surgical management, and postoperative care.
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by qwen3.7-flash, 2026-09-04
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This case report reviews perioperative management strategies for a 40-year-old patient with abdominal wall endometriosis, detailing preoperative imaging and surgical planning. The authors outline intraoperative techniques such as circumferential dissection and tension-free fascial closure, alongside postoperative activity restrictions and the deferral of medical therapy. They emphasize the importance of general surgery consultation for significant fascial involvement and highlight that optimization requires thorough anatomical understanding and careful wound closure. This paper is centrally about endometriosis — specifically the surgical excision and perioperative care of deep infiltrating lesions in the abdominal wall.
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Video Session 04 - Endometriosis |
(2:00 PM — 3:00), 2:29 PMVolume 32, Issue 11, Supplement S17-S18November 2025
Obstetrics and Gynecology, Columbia University, New York, NY
DOI: 10.1016/j.jmig.2025.09.096 External LinkAlso available on ScienceDirect External Link
Category: Endometriosis
SubCategory: Other
To review the pre, intra, and postoperative considerations for the management of abdominal wall endometriosis.
Case report.
Tertiary medical center.
40-year-old G4P0040 with an abdominal wall mass, suspicious for abdominal wall endometriosis, who desired surgical management.
The patient underwent an abdominal wall endometriosis excision with omental endometriosis excision. Perioperative considerations include:
Preoperatively:
• Obtaining an MRI for surgical planning.
• Determining the surgical approach, either laparoscopic or abdominal.
• Consulting General Surgery for disease with larger fascial involvement.
• Utilizing the rectus to defect ratio.
Intraoperatively:
• Understanding key anatomy of the abdominal wall.
• Employing traction/countertraction and circumferential dissection.
• Undermining the fascia for a tension-free primary closure.
Postoperatively:
• Instructing the patient to follow activity restrictions for 6 weeks.
• Deferring medical management for isolated abdominal wall endometriosis given the lack of evidence for disease suppression.
The patient was discharged home on postoperative day 1 and was healing well by her postoperative visit.
Abdominal wall endometriosis causes significant symptoms for patients, and complex gynecologists must be well versed in its management. Optimization for its excision by the abdominal approach includes obtaining an MRI for planning excision and closure, understanding the anatomy of the abdominal wall, and undermining the fascia for a tension-free primary closure.
This paper is only available as a PDF.
C.J. Min
Affiliations
Obstetrics and Gynecology, Columbia University, New York, NY
S. Guang
Affiliations
Obstetrics and Gynecology, Columbia University, New York, NY
C. Arora
Affiliations
Obstetrics and Gynecology, Columbia University, New York, NY
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