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Endoscopic Surgery for Athletic Pubalgia: Endoscopic Rectus Abdomis Repair and Prepubic Aponeurosis Repair Following Endoscopic Pubic Symphysectomy

March 01, 2017

Contributors: Nicole Matsuda; Dean K Matsuda, MD; Dean K Matsuda, MD

This video demonstrates complete endoscopic repair of a rectus abdominis tear and a prepubic aponeurotic avulsion. To our knowledge, this has not been previously described in the orthopaedic literature. A collegiate wrestler and football player with a recalcitrant osteitis pubis and rectus abodminis tear was diagnosed with a prepubic aponeurosis avulsion during endoscopic surgery. Using completely endoscopic techniques via an anterior and suprapubic portal, the patient underwent endoscopic pubic symphysectomy followed by repair of a vertical tear of the rectus abdominis tendon and reattachment of the avulsed prepubic aponeurosis. Outcomes are described in the video. Athletic pubalgia involving the symphysis pubis, rectus abdominis, and prepubic aponeurosis may be amenable to endoscopic repair, which harnesses the advantages of less invasive outpatient surgery.

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