CanSAGE 2022 | 26 – An approach to imaging and surgical excision of abdominal wall endometriosis
This video describes the clinical presentation of abdominal wall endometriosis (AWE), an approach to pre-operative imaging of AWE including ultrasound and magnetic resonance imaging, and an approach to surgical resection. We present two surgical cases. The first is a patient with catamenial pain in the left lower abdominal wall, a history of two previous cesarean sections and a lesion consistent with AWE on ultrasound. The second case is a patient with peri-umbilical AWE. We discuss a three-step surgical approach: 1. Landmarking and incision-making 2. Dissection and excision and 3. Fascial repair. Larger fascial defects may require fascial mobilization off surrounding tissue to allow for a tension-free closure or mesh placement in the abdominal wall, which can be done in consultation with general surgery.