Hernia

, Volume 15, Issue 6, pp 607–614 | Cite as

A systematic review on the outcomes of correction of diastasis of the recti

Review

Abstract

Purpose

Diastasis or divarication of the rectus abdominus muscles describes the separation of the recti, usually as a result of the linea alba thinning and stretching. This review examines whether divaricated recti should be repaired and tries to establish if the inherent co-morbidity associated with surgical correction outweighs the benefits derived.

Methods

EMBASE, MEDLINE and the Cochrane library were searched for (‘divarication’ OR ‘diastasis’) AND (‘recti’ OR ‘rectus’). A standard data extraction form was used to extract data from each text. Due to the lack of randomised control trials, meta-analysis was not possible.

Results

Seven studies report that patient satisfaction was high following surgery. The most common complication seen was the development of a seroma. Other common complications included haematomas, minor skin necrosis, wound infections, dehiscence, post-operative pain, nerve damage and recurrence, the rate of which may be as high as 40%.

Conclusions

Further studies are required to compare laparoscopic and open abdominoplasty techniques. Patients and physicians should be advised that correction is largely cosmetic, and although divarications may be unsightly they do not carry the same risks of actual herniation. Progressive techniques have resulted in risk reduction with no associated surgical mortality. However, the outcomes may be imperfect, with unsightly scarring, local sepsis and the possibility of recurrence.

Keywords

Divarication Recti Review Outcome 

References

  1. 1.
    Moore KL, Dalley AF (eds) (2006) Clinically orientated anatomy, 5th edn. Lippincott Williams and Wilkins, BaltimoreGoogle Scholar
  2. 2.
    Hsia M, Jones S (2000) Natural resolution of rectus abdominis diastasis. Two single case studies. Aust J Physiother 46(4):301–307PubMedGoogle Scholar
  3. 3.
    Palanivelu C, Rangarajan M, Jategaonkar PA, Amar V, Gokul KS, Srikanth B (2009) Laparoscopic repair of diastasis recti using the ‘Venetian blinds’ technique of plication with prosthetic reinforcement: a retrospective study. Hernia 13(3):287–292PubMedCrossRefGoogle Scholar
  4. 4.
    Macpherson G (ed) (1999) Black’s medical dictionary, 39th edn. Black, LondonGoogle Scholar
  5. 5.
    Nahas FX, Ferreira LM, De Arimateia Mendes J (2004) An efficient way to correct recurrent rectus diastasis. Aesthetic Plast Surg 28(4):189–196PubMedCrossRefGoogle Scholar
  6. 6.
    Pollock H, Pollock T (2000) Progressive tension sutures: a technique to reduce local complications in abdominoplasty. Plast Reconstr Surg 105(7):2583–2586PubMedCrossRefGoogle Scholar
  7. 7.
    Van Uchelen JH, Werker PM, Kon M (2001) Complications of abdominoplasty in 86 patients. Plast Reconstr Surg 107(7):1869–1873PubMedCrossRefGoogle Scholar
  8. 8.
    Huang GJ, Bajaj AK, Gupta S, Petersen F, Miles DA (2007) Increased intraabdominal pressure in abdominoplasty: delineation of risk factors. Plast Reconstr Surg 119(4):1319–1325PubMedCrossRefGoogle Scholar
  9. 9.
    Van Uchelen JH, Kon M, Werker PMN (2001) The long-term durability of plication of the anterior rectus sheath assessed by ultrasonography. Plast Reconstr Surg 107(6):1578–1584PubMedCrossRefGoogle Scholar
  10. 10.
    Nahas FX, Augusto SM, Ghelfond C (2001) Nylon versus polydioxanone in the correction of rectus diastasis. Plast Reconstr Surg 107(3):700–706Google Scholar
  11. 11.
    Bhanot A (2009) Laparoscopic abdominoplasty for divarication of recti. J Chinese Clinical Med 4(12):703–705Google Scholar
  12. 12.
    Zukowski ML, Ash K, Spencer D, Malanoski M, Moore G (1998) Endoscopic intracorporal abdominoplasty: a review of 85 cases. Plast Reconstr Surg 102(2):516–527PubMedCrossRefGoogle Scholar
  13. 13.
    Lockwood T (1998) Rectus muscle diastasis in males: primary indication for endoscopically assisted abdominoplasty. Plast Reconstr Surg 101(6):1685–1694PubMedCrossRefGoogle Scholar
  14. 14.
    Williams TC, Hardaway M, Altuna B (2005) Ambulatory abdominoplasty tailored to patients with an appropriate body mass index. Aesthet Surg J 25(2):132–137PubMedCrossRefGoogle Scholar
  15. 15.
    Ferreira LM, Castilho HT, Hochberg J, Ardenghy M, Toledo SR, Cruz R (2001) Triangular mattress suture in abdominal diastasis to prevent epigastric bulging. Ann Plast Surg 46(2):130–134PubMedCrossRefGoogle Scholar
  16. 16.
    Nahas FX, Augusto SM, Ghelfond C (1997) Should diastasis recti be corrected? Aesthetic Plast Surg 21(4):285–289PubMedCrossRefGoogle Scholar
  17. 17.
    Asaadi M, Haramis HT (1994) A simple technique for repair of rectus sheath defects. Ann Plast Surg 32(1):107–109PubMedCrossRefGoogle Scholar
  18. 18.
    Brauman D, Capocci J (2009) Liposuction abdominoplasty: an advanced body contouring technique. Plast Reconstr Surg 124(5):1685–1695PubMedCrossRefGoogle Scholar
  19. 19.
    Nahas FX, Ferreira LM, Augusto SM, Ghelfond C (2005) Long-term follow-up of correction of rectus diastasis. Plast Reconstr Surg 115(6):1736–1741PubMedCrossRefGoogle Scholar
  20. 20.
    Dabb RW, Hall WW, Baroody M, Saba AA (2004) Circumferential suction lipectomy of the trunk with anterior rectus fascia plication through a periumbilical incision: an alternative to conventional abdominoplasty. Plast Reconstr Surg 113(2):727–732PubMedCrossRefGoogle Scholar
  21. 21.
    Ramirez OM (2000) Abdominoplasty and abdominal wall rehabilitation: a comprehensive approach. Plast Reconstr Surg 105(1):425–435PubMedCrossRefGoogle Scholar
  22. 22.
    Hsia M, Jones S (2000) Natural resolution of rectus abdominis diastasis. Two single case studies. Aust J Physiother 46(4):301–307PubMedGoogle Scholar
  23. 23.
    Nahas FX, Ferreira LM (2010) Concepts on correction of the musculoaponeurotic layer in abdominoplasty. Clin Plast Surg 37(3):527–538PubMedCrossRefGoogle Scholar

Copyright information

© Her Majesty the Queen in Right of United Kingdom 2011

Authors and Affiliations

  1. 1.Department of SurgeryNorthampton General Hospital NHS TrustNorthamptonUK
  2. 2.LeicesterUK

Personalised recommendations