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Comparison of outcomes in rectus abdominis diastasis repair—which data do we need in a hernia registry?

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Abstract

Introduction

Rectus abdominis diastasis (RAD) ± concomitant hernia is a complex hernia entity of growing significance in everyday clinical practice. Due to a multitude of described surgical techniques, a so far missing universally accepted classification and hardly existing comparative studies, there are no clear recommendations in guidelines. Therefore, “RAD ± concomitant hernia” will be documented as a separate hernia entity in the Herniamed Registry in the future. For this purpose, an appropriate case report form will be developed on the basis of the existing literature.

Methods

A systematic search of the available literature was performed in March 2021 using Medline, PubMed, Google Scholar, Scopus, Embase, Springer Link, and the Cochrane Library. 93 publications were identified as relevant for this topic.

Results

In total 45 different surgical techniques for the repair of RAD ± concomitant hernia were identified in the surgical literature. RAD ± concomitant hernia is predominantly repaired by plastic but also by general surgeons. Classification of RAD ± concomitant hernia is based on a proposal of the German Hernia Society and the International Endohernia Society. Surgical techniques are summarized as groups subject to certain aspects: Techniques with abdominoplasty, open techniques, mini-less-open and endoscopic sublay techniques, mini-less-open and endoscopic subcutaneous/preaponeurotic techniques and laparoscopic techniques. Additional data impacting the outcome are also recorded as is the case for other hernia entities. Despite the complexity of this topic, documentation of RAD ± concomitant hernia has not proved to be any more cumbersome than for any of the other hernia entities when using this classification.

Conclusion

Using the case report form described here, the complex hernia entity RAD ± concomitant hernia can be recorded in a registry for proper analysis of comparative treatment options.

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Authors and Affiliations

  1. Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany

    F. Köckerling

  2. Hernia Center 3+CHIRURGEN, Klosterstrasse 34/35, 13581, Berlin, Germany

    R. Lorenz

  3. Pan Hospital, Hernia Center, Zeppelinstraße 1, 50667, Köln, Germany

    B. Stechemesser

  4. UM Hernia Center, Arabellastr. 17, 81925, München, Germany

    J. Conze

  5. DRK-Krankenhaus Clementinenhaus, Lützerodestr. 1, 30161, Hannover, Germany

    A. Kuthe

  6. Hernia Center Hamburg, Helios Mariahilf Klinik, Stader Str. 203C, 21075, Hamburg, Germany

    W. Reinpold

  7. Hanse Hernia Center, Alte Holstenstr. 16, 21031, Hamburg, Germany

    H. Niebuhr

  8. Department of Surgery I—Section Coloproctology and Hernia Surgery, Lukas Hospital, Preussenstr. 84, 41464, Neuss, Germany

    B. Lammers

  9. Marien Hospital Düsseldorf, Rochusstraße 2, 40479, Düsseldorf, Germany

    K. Zarras

  10. Medical Faculty Austria, Private Hospital Confraternitaet, Sigmund Freud Private University Vienna, 1080, Vienna, Austria

    R. Fortelny

  11. Department of General, Visceral and Thoracic Surgery, Paracelsus Medical University Salzburg, Müllner Hauptstraße 48, 5020, Salzburg, Austria

    F. Mayer

  12. ZweiChirurgen GmbH—Center for Hernia Surgery and Proctology, St. Johanns-Vorstadt 44, 4056, Basel, Switzerland

    H. Hoffmann

  13. University of Basel, Petersplatz 1, 4001, Basel, Switzerland

    H. Hoffmann

  14. Klinik Im Park Zurich (Hirslanden Group), Grossmuensterplatz 9, 8001, Zurich, Switzerland

    J. F. Kukleta

  15. Department of General and Visceral Surgery, Pius Hospital, University Hospital of Visceral Surgery, Georgstrasse 12, 26121, Oldenburg, Germany

    D. Weyhe

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  1. F. Köckerling
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  2. R. Lorenz
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Correspondence to F. Köckerling.

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F. Köckerling, R. Lorenz, B. Stechemesser, J. Conze, A. Kuthe, W. Reinpold, H. Niebuhr, B. Lammers, K. Zarras, R. Fortelny, F. Mayer, H. Hoffmann, J. F. Kukleta, D. Weyhe: nothing to disclose.

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Köckerling, F., Lorenz, R., Stechemesser, B. et al. Comparison of outcomes in rectus abdominis diastasis repair—which data do we need in a hernia registry?. Hernia 25, 891–903 (2021). https://doi.org/10.1007/s10029-021-02466-w

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