• Archives of Plastic Surgery
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• v.41 no.5
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• pp.548-549
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• 2014

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.542-547
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• 2014

Background Abdominal wall free flaps are used most frequently in autologous breast reconstruction, and these flaps require intact and robust deep inferior epigastric perforator (DIEP) vessels. Pfannenstiel incisions are often present during preoperative visits for breast reconstruction and could potentially signal compromised blood supply to the lower abdominal wall. In this study, we compared the number of DIEP vessels between patients with and without Pfannenstiel incisions undergoing autologous breast reconstruction. Methods A retrospective review of medical records was performed for patients with (study) and without (control) Pfannelstiel incisions (n=34 for each group) between June 2010 and July 2013. In addition to patient demographics, number of caesarian sections, and outcomes of free flap reconstruction, abdominal wall vasculature was compared using the preoperative computed tomography angiographic data between the groups. For each patient, vessels measuring greater than 1 mm were counted and divided into four sections of the lower abdominal wall. Results The mean number of perforator vessels was 10.6 in the study group and 11.4 in the control group, which was not statistically different (P=0.575). Pfannenstiel incisions with history of repeat caesarian sections were not associated with decreased number of perforator vessels. Conclusions Pfannenstiel scars are associated with neither a change in the number of DIEP vessels nor decreased viability of a free transverse rectus abdominis myocutaneous and DIEP flap. Lower abdominal free flaps based on DIEP vessels appear safe even in patients who have had multiple caesarian sections through Pfannenstiel incisions.

• The Korean Journal of Pain
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• v.29 no.3
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• pp.193-196
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• 2016

Ilioinguinal and iliohypogastric (II/IH) nerve injury is one of the most common nerve injuries following pelvic surgery, especially with the Pfannenstiel incision. We present a case of intractable groin pain, successfully treated with a continuous II/IH nerve block. A 33-year-old woman, following emergency cesarean section due to cephalopelvic disproportion, presented numbness in left inguinal area and severe pain on the labia on the second postoperative day. The pain was burning, lancinating, and exacerbated by standing or movement. However, she didn't want to take additional medicine because of breast-feeding. A diagnostic II/IH nerve block produced a substantial decrease in pain. She underwent a continuous II/IH nerve block with a complete resolution of pain within 3 days. A continuous II/IH nerve block might be a goodoption for II/IH neuropathy with intractable groin pain in breast-feeding mothers without adverse drug reactions in their infants.

• Obstetrics & gynecology science
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• v.61 no.6
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• pp.693-697
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• 2018

Aggressive angiomyxoma (AA) is a very rare mesenchymal tumor most commonly found in the pelvic and perineal regions. For the complete excision of retrorectal tumors, with extension through the levator muscle into the ischioanal space, open anterior and posterior approaches are typically required. Herein, we report our experience with robotic excision of a giant presacral AA with extralevator extension into the ischioanal space and extraction via Pfannenstiel incision, which we found to be technically feasible, efficacious, and safe to perform. Mayo Clinic Institutional Review Board exemption status was obtained for this study.

• Clinical and Experimental Reproductive Medicine
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• v.20 no.2
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• pp.177-181
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• 1993

Endometriosis involving sites outside the pelvic cavity is a relatively uncommon occurrence and its frequency is cited as being less than one percent of all occurences of endometriosis. Sites previously reported in literature have described involvement of the extraperitoneal portion of the round ligament, the rectosigmoid, the appendix, and the ileum. Other more distal sites reported to have been found to have endometriosis lesions include the inguinal ligaments, the umbilicus, abdominal incisional wounds, thoracic lesions involving the pleura or diaphragm which may result in catamenial pneumothorax, the kidneys, and vulvar episiotomy wounds. Endometriosis have even been reported to occur in males. In this presentation, three cases of endometriosis, two involving the vulvar area and one involving a Pfannenstiel incision wound, is presented with a review of the pertinent literature in order to discuss its etiology, pathology, diagnosis and treatment.