CanSAGE 2022 | 70 – Resection of Ischiorectal Endometriosis and Martius Flap Reconstruction

Video Description

Ischiorectal endometriosis is rare and can be associated with vaginal delivery and birth trauma. In this video, we present the case of a 34-year-old patient who presents with progressively worsening perineal pain after childbirth. An MRI confirms an endometriosis nodule in the ischiorectal fossa. We have described an approach to resection using a trans-ischiorectal fossa approach and subsequent reconstruction with a Martius flap. Rotational grafts such as the Martius flap have been used for fistula repair and are less invasive when compared to gluteal or gracilis flaps. We describe a two-step approach as a feasible strategy to avoid an invasive rotational flap. This video aims to provide a step-by-step approach to both resection and reconstruction while providing an overview of perineal anatomy.

Presented By

Dr. Anna Kobylianskii
Dr. Nucelio Lemos