Postpartum Divarication Navel-Sparing Treatment by Multidisciplinary Approach
PPAWI (postpartum abdominal wall insufficiency) is a new acronym introduced in 2013. This pathological condition is induced by abdominal distension during pregnancy. It consists of general laxity of the anterior abdominal wall and of excess skin and panniculus. This has important repercussions on abdominal wall function and its aesthetics.
Surgery is advised when the impaired abdominal wall function is symptomatic and/or the women have aesthetic problems. We propose a retro-muscular mesh augmentation when the maximum inter-recti distance (IRD) is more than 4 cm in width or if there is a concomitant umbilical or epigastric hernia. We propose our one-step multidisciplinary surgical approach to treat PPAWI. During this surgery, the panniculectomy to address the excess of skin is done by a plastic surgeon. The retro-muscular mesh augmentation of the abdominal wall to treat the rectus diastasis is done by the abdominal wall surgeon.