Painful endometrial implants to the abdominal wall: minimally invasive treatment with percutaneous cryoablation with laparoscopic assistance.

In this case report, we describe a young woman presenting with long-standing severe abdominopelvic pain caused by abdominal wall endometrial implants. Due to the location, surgical resection was felt to be excessively morbid. Cryoablation entails the image-guided insertion of specialised needles into the tissue to induce tissue freezing and necrosis for the treatment of a variety of disease processes. However, percutaneous cryoablation was deemed impractical due to the implant's location and risk of injury to the bladder and bowel. Using a hybrid approach of laparoscopic dissection of the bowel and bladder away from the abdominal wall to allow concurrent ultrasound-guided cryoablation, the implant was successfully ablated. Once recovered, she had a resolution of pain. Cryoablation is an effective method to treat painful endometrial implants to the abdominal wall with minimal morbidity.

Duke Scholars

Author Dan German Blazer III Surgical Oncology

Author Charles Yoon Kim Radiology, Interventional Radiology