Autotransplantation of the posterior rectus sheath for closure of abdominal wall resections due to tumour

We present a remedial procedure for abdominal wall closure after abdominal wall resections of tumour origin. This is a 37-year-old female patient with no previous history, referred for surgical treatment of a desmoid tumour resistant to Raloxifene. Resection of the tumour and subsequent unfolding of the posterior sheath covering a 20 × 7 cm defect was performed (Fig. 1). The internal margins of the left rectum and the anterior sheath of the right rectum were sutured with non-absorbable suture. Pathology reported R0 resection. There were no postoperative complications. There was no hernia recurrence or bulging at 6 months.

Fig. 1.

A) Detail of the extraction of the posterior rectal sheath. B) Enlargement of the dissection in the posterior rectal sheath for flap extraction. C) Implantation of the flap in the upper defect. D) Dissection of the posterior rectal sheath in the patient. E) Re-implantation of the posterior sheath in the defect.