Surgical treatment of diastasis recti: the importance of an overall view of the problem

Abstract

Purpose

Diastasis recti (DR) is characterized by an alteration of the linea alba with increased inter-recti distance (IRD). It is more frequent in females, and when symptomatic or associated with midline hernia it needs to be surgically repaired. This retrospective study aims to demonstrate how an overall approach to DR leads to good results in terms of functional and morphological outcomes and quality of life (QoL).

Methods

From January 2018 to December 2019, 94 patients were operated for DR > 50 mm, with or without midline hernias. Three different surgical approaches were used: complete laparoabdominoplasty, laparominiabdominoplasty and minimally invasive (endoscopic) technique. QoL was assessed with the EuraHS-QoL tool.

Results

All patients were female except two males. We performed 26 endoscopic treatments (27.7%), 39 laparoabdominoplasties (41.5%) and 29 laparominiabdominoplasties (umbilical float procedure) (30.9%). The total median operative time was 160 min. No intraoperative complications were registered. In three (4.2%) cases, major surgical complications occurred, all after open operations. In 13 open surgery cases, vacuum-assisted closure (VAC) therapy was used to repair the cutaneous ischemic defect. No recurrence was registered to date. Minimally invasive surgery showed fewer complications and lower hospital stay than the open approach. The QoL was significantly improved.

Conclusion

Our experience shows the importance of an overall view of the functional and cosmetic impairment created by DR. The surgeon should obtain an optimal repair of the function, by open or minimally invasive surgery, also considering the morphological aspects, which are very important for the patients in terms of QoL.

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Contributions

FF and FF: design, conception and writing; FF: data analysis; DG and DG: data acquisition; MS: supervision.

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Correspondence to Francesco Ferrara.

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The procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Formal informed consent was obtained from all patients.

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All patients provided informed consent. 

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Fiori, F., Ferrara, F., Gobatti, D. et al. Surgical treatment of diastasis recti: the importance of an overall view of the problem. Hernia (2020). https://doi.org/10.1007/s10029-020-02252-0

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Keywords

  • Diastasis recti
  • Surgery
  • Minimally invasive
  • Abdominal wall
  • Hernia