Application of the mesh bridging technique in the excision of abdominal endometriosis lesions: Case report and literature review

Yingying Chen, Lifang Wu, Cheng Qian, Wenting Wu, Boliang Chu, Jie Dong
International Journal of Gynecology & Obstetrics · 2025 · vol. 168(2) , pp. 449–455 · doi:10.1002/ijgo.15913 · PMID:39284768
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report describes the successful use of a mesh bridging technique with biological and polypropylene meshes for abdominal wall reconstruction following excision of a large abdominal wall endometriosis lesion.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 · read from full text ⓘ

This paper describes a case report and literature review on abdominal wall scar endometriosis, focusing on surgical resection of abdominal lesions and subsequent abdominal wall reconstruction when large tissue defects require reinforcement. A 34-year-old woman with cyclic low abdominal wall pain after two cesarean sections had a 6×5×3 cm mass above the symphysis pubis, with diagnosis supported by abdominal ultrasound and MRI, and underwent complete excision of endometriosis with reconstruction using a mesh bridging approach combining biological mesh near the peritoneal side and polypropylene mesh over it. The authors report the technique as aiming to limit peritoneal stimulation from polypropylene while improving strength and reducing risk of abdominal wall hernia, and they state the patient achieved good therapeutic results and satisfaction. The paper is centrally about endometriosis — it specifically presents and reviews a mesh-bridging method for excision and reconstruction in abdominal wall scar endometriosis.

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Abstract

Abdominal wall scar endometriosis (AWE) is a rare endometriosis that usually occurs after gynecological or obstetric surgery and for which surgical resection is the standard treatment. For large tissue defects after resection, abdominal wall reconstruction is needed. Here, we describe a mesh bridging technique using biological and polypropylene meshes for abdominal wall reconstruction. A 34-year-old woman visited the center with complaints of low abdominal wall pain during menstruation for more than 5 years. Her surgical history included undergoing a cesarean section delivery twice. A mass measuring 6 cm × 5 cm × 3 cm was found above the symphysis pubis in the lower part of the abdominal incision. Endometriosis lesion was considered based on abdominal ultrasound and magnetic resonance imaging findings. After a multidisciplinary discussion that included surgical experts and gynecologists, the decision was made to perform abdominal endometrial focus excision plus abdominal wall reconstruction. Two kinds of mesh were skillfully used in the operation of this patient. Biological mesh was used close to the peritoneal side and covered with polypropylene mesh to reduce the stimulation by the polypropylene mesh of the peritoneum, enhance the strength of the biological mesh, and reduce the incidence of abdominal wall hernia. Our case demonstrates that accurate diagnosis of AWE followed by complete resection and reconstruction of the abdominal wall using a combination of biological and polypropylene mesh bridging can achieve good therapeutic results and patient satisfaction.
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Application of the mesh bridging technique in the excision of abdominal endometriosis lesions: Case report and literature review Abstract Abdominal wall scar endometriosis (AWE) is a rare endometriosis that usually occurs after gynecological or obstetric surgery and for which surgical resection is the standard treatment. For large tissue defects after resection, abdominal wall reconstruction is needed. Here, we describe a mesh bridging technique using biological and polypropylene meshes for abdominal wall reconstruction. A 34-year-old woman visited the center with complaints of low abdominal wall pain during menstruation for more than 5 years. Her surgical history included undergoing a cesarean section delivery twice. A mass measuring 6 cm × 5 cm × 3 cm was found above the symphysis pubis in the lower part of the abdominal incision. Endometriosis lesion was considered based on abdominal ultrasound and magnetic resonance imaging findings. After a multidisciplinary discussion that included surgical experts and gynecologists, the decision was made to perform abdominal endometrial focus excision plus abdominal wall reconstruction. Two kinds of mesh were skillfully used in the operation of this patient. Biological mesh was used close to the peritoneal side and covered with polypropylene mesh to reduce the stimulation by the polypropylene mesh of the peritoneum, enhance the strength of the biological mesh, and reduce the incidence of abdominal wall hernia. Our case demonstrates that accurate diagnosis of AWE followed by complete resection and reconstruction of the abdominal wall using a combination of biological and polypropylene mesh bridging can achieve good therapeutic results and patient satisfaction. CONFLICT OF INTEREST STATEMENT The authors declare that they have no conflict of interest. DATA AVAILABILITY STATEMENT Data sharing is not applicable to this article as no new data were created or analyzed in this study.

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Condition tags

endometriosis

MeSH descriptors

Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall Abdominal Wall

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