Joint Treatment of De Novo Umbilical Endometriosis with Plastic Surgery and Minimally Invasive Gynecologic Surgery

Abstract

Study Objective The purpose of this report is to visually document the surgical steps of a novel four-flap umbilicoplasty in the treatment of primary cutaneous umbilical endometriosis. Design This is a case report and surgical video presenting information gathered from chart review. Patient consent was obtained verbally and documented in the medical record. Setting The intervention was performed in a standard operating room of a community hospital located in an urban area. Patients or Participants This patient is a 36-year-old gravida 1 para 0 who presented to MIGS with a decade long history of cyclic pain and bleeding from primary cutaneous umbilical endometriosis. Symptom control was refractory to cauterization by general gynecology. She was counseled on a joint procedure with MIGS and plastic surgery. Interventions The patient underwent diagnostic laparoscopy and resection of intraperitoneal endometrial implants with MIGS. She underwent umbilical endometriosis resection with a novel four-flap umbilicoplasty with plastic surgery. She followed up appropriately postoperatively with both surgical teams without complication. Measurements and Main Results Patient reported symptom control and satisfaction with cosmetic result. Provider noted satisfactory cosmetic result and lack of complication, including infection at the surgical site. Conclusion This video demonstrates a novel treatment approach to primary cutaneous umbilical endometriosis via four-flap umbilicoplasty. The surgery was performed jointly with MIGS and plastic surgery. Interspecialty collaboration was a key aspect of this patient's care in providing symptom relief as well as a cosmetically appearing outcome.