To explore the effectiveness, safety and feasibility of mesh repair in the treatment of abdominal wall fascia defect after laparoendoscopic single-site surgery for abdominal wall endometriosis (AWE) resection.

The clinical data of 5 patients who underwent laparoendoscopic single-site surgery AWE lesion resection and 6 patients who underwent AWE lesion resection via the original cesarean section incision with intraoperative mesh repair of fascia defects from Jun. 2023 to Dec. 2024 in the First Affiliated Hospital of Nanjing Medical University were collected. The AWE lesions were completely resected using either the laparoendoscopic single-site surgery or the original cesarean section incision. Preoperative ultrasound and MRI were performed to evaluate the size and location of the AWE. The location of the AWE, the extent of the fascia defect after resection, the adverse reactions related to mesh placement, the pathological results of the lesion and the perioperative complications were compared between the two groups of patients.

All the 5 patients who underwent laparoendoscopic single-site surgery and 6 patients who underwent surgery through the original cesarean section had successful surgeries. There was less bleeding during the laparoendoscopic single-site surgery, and the postoperative pathology showed endometriosis and negative surgical margins. All incisions healed well with grade A, and no adverse reactions related to mesh placement occurred.

After minimally invasive radical resection of AWE, the fascia defect is too large to be sutured. Mesh can be used to fill and repair the fascia defect to ensure the original tension of the abdominal wall. Compared with the conventional surgery through the original cesarean section incision, laparoendoscopic single-site surgery has the advantages of smaller incision and faster postoperative recovery. This technique is safe and feasible for clinical application.