Abdominal tattoo can be useful to avoid a midline abdominal incision

Abstract

We report a case in which abdominal tattoo margins were modified and used to hide the surgical incision for desmoid tumour removal. Our patient is a 37-year-old female with history remarkable for atrial septal defect closure at the age of ten, but not for previous abdominal surgeries or trauma. A desmoid tumour diagnosis was made upon needle biopsy of the 5 × 4 cm2 mass confined to the rectus abdominis. Subsequently, tumour was resected with an incision through the tattoo upper margin and abdominal wall was reconstructed with primary fascial closure mesh reinforced. Excision was radical, scar inconspicuous and no incisional hernia, bulging, nor tumour recurrence were detected at 2-year follow-up. This report highlights the fact that an abdominal tattoo might be considered as incision access instead of typical midline incision.

Tattoos in the Operative Field: The State of the Art

“…To date, proposed techniques for tattoo management include moving the incision wherever possible, 9,10 using minimally invasive techniques to reduce the incision size, 9,11 and hiding incisions within the contours of tattoos. [10][11][12][13][14][15][16][17] Most literature has described tattoos within the abdominal 9,10,13,15 and lumbar regions, 11,17 where surgeons have the option of avoiding tattoos by adjusting laparoscopic port sites or retractor placement. 9,11 There is little information about best practices for tattoos encountered in more complex anatomical regions, such as the upper extremities.…”