Case Report: Bioresorbable implant in anterior abdominal wall reconstruction in women of reproductive age. Case Report with pregnancy and a 10-year follow-up.

Introduction: Surgical management of anterior abdominal wall hernias in women of reproductive age remains challenging, as repair techniques must accommodate physiological changes during pregnancy. While permanent synthetic meshes are effective, concerns exist regarding their mechanical behavior in the context of pregnancy in this patient population. Bioresorbable implants have emerged as a potential alternative; however, clinical data on pregnancy outcomes remain limited. Aim: To present a case of abdominal wall reconstruction using a bioresorbable poly-4-hydroxybutyrate (P4HB, Phasix®) mesh with subsequent pregnancy and long-term follow-up. Case description: A 42-year-old woman with a history of recurrent linea alba hernia and diastasis underwent retromuscular repair using a P4HB mesh. Sixteen months later, she conceived. Pregnancy and delivery were uneventful, with no abdominal wall-related symptoms. At 10-year follow-up, ultrasonography demonstrated no hernia recurrence, and laparoscopic inspection confirmed complete mesh resorption with preserved integrity of the linea alba. Conclusions: In this case, the use of a bioresorbable P4HB mesh was associated with an uncomplicated pregnancy and durable long-term outcome. However, given the single-case design and small defect size, these findings should be interpreted with caution and require confirmation in larger studies.