Preventable surgical complication: insights from 33 abdominal wall endometriosis cases

Güven Erdoğrul, Güvenç Diner, Samed Sayar, Hacer Ece Özcan, Hamdi Özcan, Tuna Ayas
In: Cukurova Medical Journal · 2025 · vol. 50(3) , pp. 944–948 · doi:10.17826/cumj.1665736 · W4414468367
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study analyzed 33 abdominal wall endometriosis cases, finding lesions at Pfannenstiel incision lines, and concluded the complication is preventable by avoiding residual vicryl and intraoperative contamination during cesarean sections.

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

This retrospective study evaluated diagnosis, treatment, and follow-up outcomes in 33 surgically treated patients with abdominal wall endometriosis (2021–2024), analyzing age, interval from last pelvic surgery to excision, lesion location and size, mesh use, and recurrence. All patients had lesions detected along the Pfannenstiel incision line, with 32 reporting prior cesarean section and one prior oophorectomy; lesions were described in right corner (19), left corner (12), and midline (2). Over a mean follow-up of 47.24±25.07 months, there was no observed recurrence or hernia. The study’s caveat is that it is a retrospective case series focused on surgical outcomes and provides no control group to directly test preventability claims. This paper is centrally about endometriosis — specifically abdominal wall endometriosis as a preventable surgical complication, which is highly relevant to endometriosis research and management considerations.

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Abstract

Purpose: The aim of this study was to report the diagnosis, treatment and follow-up results of patients operated with the diagnosis of abdominal wall endometriosis and to investigate its preventability. Materials and Methods: This retrospective study included 33 patients who underwent surgery for abdominal wall endometriosis between 2021 and 2024. Diagnostic processes, treatment and follow-up results of the patients were evaluated. Patients were analyzed in terms of age, during from the last pelvic surgery to endometriosis excision, endometriosis location, endometriosis size, mesh use and recurrence. Results: 33 patients were included in the study and the mean age was 32.91±5.64 years. Endometriosis lesions were detected at the Pfannenstiel incision line in all patients, 32 of them had a history of cesarean section and 1 patient had a history of oophorectomy. The lesions were located in the right corner in 19 patients, in the left corner in 12 patients and in the midline of the incision line in 2 patients. Follow-up period was 47.24±25.07 months and no recurrence or hernia was observed in any of the patients. Conclusion: Abdominal wall endometriosis is a preventable complication, and it is necessary to avoid using the remaining vicryl in the fascia during uterine closure during cesarean section and to prevent intraoperative contamination.
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Abstract

Purpose: The aim of this study was to report the diagnosis, treatment and follow-up results of patients operated with the diagnosis of abdominal wall endometriosis and to investigate its preventability.

Materials and methods

This retrospective study included 33 patients who underwent surgery for abdominal wall endometriosis between 2021 and 2024. Diagnostic processes, treatment and follow-up results of the patients were evaluated. Patients were analyzed in terms of age, during from the last pelvic surgery to endometriosis excision, endometriosis location, endometriosis size, mesh use and recurrence.

Results

33 patients were included in the study and the mean age was 32.91±5.64 years. Endometriosis lesions were detected at the Pfannenstiel incision line in all patients, 32 of them had a history of cesarean section and 1 patient had a history of oophorectomy. The lesions were located in the right corner in 19 patients, in the left corner in 12 patients and in the midline of the incision line in 2 patients. Follow-up period was 47.24±25.07 months and no recurrence or hernia was observed in any of the patients.

Conclusion

Abdominal wall endometriosis is a preventable complication, and it is necessary to avoid using the remaining vicryl in the fascia during uterine closure during cesarean section and to prevent intraoperative contamination.

Keywords

Caesarean, Endometriosis, Excision Önlenebilir cerrahi bir komplikasyon: 33 karın duvarı endometriozis olgusunun bulguları

Abstract

Amaç: Bu çalışmda karın duvarı endometriozisi tanısı ile opere edilen hastaların tanı, tedavi ve takip sonuçlarını bildirmek ve önlenebilirliğini araştırmak amaçlandı. Gereç ve Yöntem: Bu retrospektif çalışmaya 2021 ile 2024 tarihleri arasında karın duvarı endometriozisi tanısı ile opere edilen 33 hasta dahil edildi. Hastaların tanı süreçleri, tedavi ve takip sonuçları değerlendirildi. Hastaların yaş, son pelvik cerrahiden endometriozis eksizyonuna kadar geçen süre, endometriozis yerleşim yeri, endometriozis büyüklükleri, mesh kullanımı ve nüks durumu açısından analiz edildi. Bulgular: Çalışmaya 33 hasta dahil edilmiştir ve yaş ortalaması 32,91±5,64 yıl olarak hesaplandı. Hastaların hepsinde endometriozis lezyonları Pfannenstiel insizyonu hattında tespit edilmiştir ve 32’sinin öyküsünde sezaryen, 1 hastanın öyküsünde ise ooferektomi mevcuttu. Lezyonların yerleşimi incelendiğinde; 19 hastada sağ köşede, 12 hastada sol köşede ve 2 hastada insizyon hattının orta hattında olduğu belirlenmiştir. Takip süresi 47,24±25,07 ay olan hastaların hiçbirinde nüks ve herni izlenmedi. Sonuç: Karın duvarı endometriozisi önlenebilir bir komplikasyon olup, sezaryen sırasında uterus kapatılmasında kullanılan ve kalan vikrilin fasyada kullanılmaması ve intraoperatif kontaminasyonun önlenmesi gerekmektedir.

Keywords

Eksizyon, Endometriozis, Sezeryan No financial support was used by authors during this study. Ethical permission was obtained from the Mersin University, Medical Faculty Clinical Research Ethics Committee for this study with date 27/11/2024 and number 2024/1160.

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Condition tags

endometriosis

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