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Guerron AD, Restrepo-Rodas G, Barajas-Gamboa JS, Guzman Fuentes JL, Pantoja JP, Abril C, Al-Baqain S, Bravo M, Cherubino M, Rodriguez J. Diastasis Recti with Concomitant Ventral Hernia Repair: An Initial Experience in the United Arab Emirates Population. J Laparoendosc Adv Surg Tech A 2024; 34:904-909. [PMID: 39172557 DOI: 10.1089/lap.2024.0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024] Open
Abstract
Introduction: Diastasis recti (DR) is characterized by an abnormal separation between the rectus abdominis muscles. Traditional repair includes only plication; however, complications may arise in the presence of concurrent ventral hernias (VH). This study aims to evaluate the safety and feasibility of diastasis repair in a United Arab Emirates (UAE) population. Methods and Procedures: This retrospective cohort study was conducted with IRB approval. All patients who underwent a DR repair (DRR) with concomitant ventral hernia repair between October 2022 and February 2024 were included. Results: A total of 20 patients were included in the study. The cohort was 80% female, with a mean overall age of 44.05 years. The mean body mass index was 27.4 kg/m2. All patients (100%) presented with DR associated with an abdominal wall defect; 17 patients (85%) with umbilical hernia, 2 patients (10%) with umbilical and incisional hernia, and 1 patient (5%) with umbilical with epigastric hernia. A total of 12 (60%) patients underwent laparoscopic DRR concomitant with VH repair, 5 (25%) patients underwent open DRR with VH repair and abdominoplasty, and 1 patient (5%) underwent DRR with VH repair and liposuction. All cases were successful without complications or conversions. Complications within 30 days included only seromas in 6 patients (30%), one requiring drainage. Conclusion: Our initial experience suggests that DR repair with concomitant VH repair and/or abdominoplasty is feasible and safe in the UAE population. Our experience demonstrated surgical outcomes compared to other regions in the world.
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Affiliation(s)
- Alfredo D Guerron
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | - Juan S Barajas-Gamboa
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | - Juan Pablo Pantoja
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Carlos Abril
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Suleiman Al-Baqain
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Miguel Bravo
- Department of Plastic Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Mario Cherubino
- Department of Plastic Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - John Rodriguez
- Department of General Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
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Taritsa IC, Dumanian GA. Long-term outcomes of open midline ventral hernia repair using a narrow well-fixed retrorectus polypropylene mesh. Hernia 2024:10.1007/s10029-024-03133-6. [PMID: 39214935 DOI: 10.1007/s10029-024-03133-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION The ultimate measure of successful abdominal wall reconstruction is a pain-free, complication-free, and durable hernia repair. Open techniques have generally lost favor, but they still have much to offer for patients with skin deficits and excess. The long-term complication rates for open hernia repairs is unknown. Electronic medical records now provide the ability to easily follow patients who have switched medical institutions. Using this tool, we followed a cohort of abdominal wall reconstruction patients who had an early high "success" rate. METHODS We performed a retrospective chart review of 101 patients who underwent open ventral hernia repair with a narrow well-fixed retrorectus uncoated polypropylene mesh by a single surgeon (GAD) between the years of 2010 and 2015. These patients were initially reported in a 2016 publication. Patients' post-operative follow-up by any medical provider assessing the abdominal region were studied up until August 2023. Patient demographics, operative reports, and postoperative course were re-reviewed. RESULTS A total of 101 patients underwent ventral hernia repair. Mean follow-up time was 7.68 years (range 1.8 - 13.0 years). There were no recurrent hernias across the studied time period and no instances of enterocutaneous fistulas. 15 patients (15%) had abdominal surgery after hernia repair unrelated to their original surgery and 5 patients (5%) reported chronic post-operative pain. 13 patients died in the follow-up period, all unrelated to the abdominal wall surgery. CONCLUSION Open well-fixed narrow retrorectus mesh hernia repairs perform well in the long-term without fistulas, extrusions, and hernia recurrence.
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Affiliation(s)
- Iulianna C Taritsa
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, 259 E Erie St., Suite 20-2060, Chicago, Illinois, 60611, USA
| | - Gregory A Dumanian
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Feinberg School of Medicine, Northwestern University, 259 E Erie St., Suite 20-2060, Chicago, Illinois, 60611, USA.
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Moharaq KA, El Fahar MH, Shouman OO, Hassan AA, El-Shebly AM. Clinical and Radiological Evaluation of Onlay Mesh Abdominoplasty in Obese Multiparous Patients with Moderate-to-Severe Rectus Diastasis. Aesthetic Plast Surg 2024; 48:1778-1789. [PMID: 37978087 DOI: 10.1007/s00266-023-03743-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Women with multiple pregnancies often experience abdominal protrusion and/or a lax abdominal wall. Various open surgical techniques have been developed to address rectus diastasis in abdominoplasty, ranging from suture plication to mesh reinforcement. This study aims to compare the clinical and radiological changes between traditional abdominal plication and the addition of non-absorbable mesh for rectus muscle (RM) diastasis repair in terms of function, postoperative outcome, and recurrence. PATIENTS AND METHOD This prospective retrospective study involved 63 women who underwent cosmetic tummy tuck surgery and met certain eligibility criteria. Patients with only mild diastasis recti, midline hernia, contraindications for major surgery, recent smoking history, or refusal of mesh augmentation were excluded. Clinical examination for abdominal protrusion or bulging and CT imaging was performed to check for recurrence of diastasis recti. The study included 33 patients who underwent mesh repair and 30 who underwent traditional abdominal plication. Follow-up was conducted after 1 year using CT and a questionnaire to assess various factors compared to preoperative measurements, with overall satisfaction rated on a 10-point Likert scale. RESULTS There was no significant difference in demographic data between the two groups. Patients who underwent mesh repair had a slightly longer hospital stay and drain duration. The average waist circumference decreased in both groups without any statistically significant difference. Objective CT showed significant reductions in both groups in inter-rectus distance, RM width and circumference, and intra-abdominal circumference compared to preoperative values. All patients expressed satisfaction with scar quality and umbilicus aesthetics, and no recurrence was detected either clinically or radiologically during the follow-up period. CONCLUSION Comprehensive preoperative assessment and imaging techniques like ultrasound and CT scans allow surgeons to detect postpartum changes in the abdominal wall. Mesh reinforcement may be indicated for diastasis above 4 cm in obese multiparous females. Thorough preoperative evaluation permits customized surgical plans to optimally restore abdominal wall anatomy and function. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266 .
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Affiliation(s)
| | - Mohammed H El Fahar
- Plastic and Reconstructive Surgery Department, Faculty of Medicine, Mansoura Univeristy, 60 El Gomhoria St, Mansoura, 35516, Egypt.
| | - Omar O Shouman
- Plastic and Reconstructive Surgery Department, Faculty of Medicine, Mansoura Univeristy, 60 El Gomhoria St, Mansoura, 35516, Egypt
| | - Ahmed A Hassan
- Radiology Department, Faculty of Medicine, Mansoura University, 60 El Gomhoria St, Mansoura, 35516, Egypt
| | - Ahmed M El-Shebly
- Plastic and Reconstructive Surgery Department, Faculty of Medicine, Mansoura Univeristy, 60 El Gomhoria St, Mansoura, 35516, Egypt
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Fadavi D, Gusenoff JA. Commentary on: Alternative Abdominal Wall Plication Techniques: A Review of Current Literature. Aesthet Surg J 2023; 43:869-871. [PMID: 37140009 DOI: 10.1093/asj/sjad131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 05/01/2023] [Indexed: 05/05/2023] Open
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Zingaretti N, Intini SG, Albanese R, De Francesco F, Riccio M, Parodi PC. Umbilicus Necrosis During Mesh Repair of Rectus Diastasis for Abdominoplasty: Practical Tips for Prevention and Treatment. Aesthetic Plast Surg 2023; 47:28-31. [PMID: 35428917 DOI: 10.1007/s00266-022-02879-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 11/29/2022]
Abstract
Rectus muscles widened by pregnancy are handled in dramatically different ways in standard abdominoplasty and mesh abdominoplasty. Patients with significant abdominal wall laxity and/or umbilical hernia repair are treated with the use of retrorectus mesh placement. In these conditions the risk of damaging the blood supply to the umbilicus might be greater. Despite the fact that it is of no functional significance in adults, the umbilicus is a key esthetic landmark of the anterior abdominal wall. For both patients and surgeons alike, its absence, distortion, or misplacement after surgery can be distressing and can be a source of frequent patient complaint. Umbilical stalk necrosis represents an underreported yet important complication for patients following mesh abdominoplasty. We advance some recommendations for patients undergoing abdominoplasty with mesh repair of rectus diastasis and/or concomitant umbilical hernia mesh repair via the open approach. This information should help influence intraoperative decision-making to prevent the development of this undesirable complication.Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Nicola Zingaretti
- Clinic of Plastic and Reconstructive Surgery, Department of Medical Area (DAME), Academic Hospital of Udine, University of Udine, Udine, Italy.
- Research and Training Center in Regenerative Surgery, Accademia del Lipofilling, Jesi, Ancona, Italy.
- Department of Neuroscience, Biomedicine and Movement, Human Anatomy and Histology Section, University of Verona, 37135, Verona, Italy.
| | - Sergio Giuseppe Intini
- Department of General Surgery, Department of Medical Area (DAME), Academic Hospital of Udine, University of Udine, Udine, Italy
| | - Roberta Albanese
- Clinic of Plastic and Reconstructive Surgery, Department of Medical Area (DAME), Academic Hospital of Udine, University of Udine, Udine, Italy
| | - Francesco De Francesco
- Research and Training Center in Regenerative Surgery, Accademia del Lipofilling, Jesi, Ancona, Italy
- Department of Reconstructive Surgery and Hand Surgery, AOU Ospedali Riuniti, Ancona, Italy
| | - Michele Riccio
- Research and Training Center in Regenerative Surgery, Accademia del Lipofilling, Jesi, Ancona, Italy
- Department of Reconstructive Surgery and Hand Surgery, AOU Ospedali Riuniti, Ancona, Italy
| | - Pier Camillo Parodi
- Clinic of Plastic and Reconstructive Surgery, Department of Medical Area (DAME), Academic Hospital of Udine, University of Udine, Udine, Italy
- Research and Training Center in Regenerative Surgery, Accademia del Lipofilling, Jesi, Ancona, Italy
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Bayoux R, Gignoux B, Barani C, Mabrut JY, Mojallal A. Endoscopic treatment of diastasis recti: Training method and literature review. ANN CHIR PLAST ESTH 2023:S0294-1260(23)00016-X. [PMID: 37121846 DOI: 10.1016/j.anplas.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/26/2023] [Accepted: 03/13/2023] [Indexed: 05/02/2023]
Abstract
INTRODUCTION Endoscopic treatment of diastasis rectus abdominis offers the possibility of correcting the condition without complete abdominoplasty. The purpose of this study was to develop a training method on fresh cadavers models based on a literature review on this surgery. MATERIAL AND METHODS The endoscopic procedure considered involved the insertion of a 10mm suprapubic trocar and of 5mm trocars in each iliac fossae. The muscle suture is done using running barbed suture. The surgery was performed on eight fresh cadavers to estimate the learning curve for this intervention, which was estimated with the CUSUM method. A systematic literature review in the PubMed database was performed, and 20 articles that met the inclusion criteria were analyzed. RESULTS The learning curve threshold was reached after 6 operations and can be separated into two phases. The most common complication of this surgery is seroma, it is encountered in 3 to 27% of cases according to the studies. Diastasis recurrence is rare, occurring in less than 2% of cases. In comparison, open surgical treatment of diastasis recti is associated with a higher risk of hematoma, skin necrosis and longer operating times. Recurrence rates are similarly low after open and endoscopic repair. Mesh reinforcement is indicated in cases of diastasis wider than 5cm, diastasis recurrence, severe musculoaponeurotic laxity, or hernia larger than 1cm. CONCLUSION The data in the literature indicate that laparoscopic surgery is an efficient and safe approach to correct diastasis of the rectus muscles and can be offered by plastic surgeons to selected patients.
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Affiliation(s)
- Robin Bayoux
- Department of Plastic and Reconstructive Surgery, Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Lyon I, UCBL 1, 103, Grande Rue de la Croix-Rousse, 69004 Lyon, France
| | - Benoit Gignoux
- Department of General, Visceral and Endocrine Surgery, Clinique de la Sauvegarde, 480, avenue Ben-Gourion, 69009 Lyon, France
| | - Camille Barani
- Department of Plastic and Reconstructive Surgery, Saint-Joseph-Saint-Luc Hospital, 20, quai Claude-Bernard, 69003 Lyon, France
| | - Jean-Yves Mabrut
- Department of General Surgery and Liver Transplantation, Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Lyon I, 103, Grande Rue de la Croix-Rousse, 69004 Lyon, France
| | - Ali Mojallal
- Department of Plastic and Reconstructive Surgery, Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Lyon I, UCBL 1, 103, Grande Rue de la Croix-Rousse, 69004 Lyon, France.
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Moradian S, Klosowiak JL, Boctor MJ, Issa T, Park S, Dumanian GA. Novel Approach for Umbilical Hernia Repair Using Mesh Strips. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4947. [PMID: 37113310 PMCID: PMC10129195 DOI: 10.1097/gox.0000000000004947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/24/2023] [Indexed: 04/29/2023]
Abstract
Umbilical hernia repair is a common surgical procedure without a universally accepted means of repair. We introduce a novel surgical technique for open primary umbilical hernia repair, using strips of polypropylene mesh as sutures to achieve a repair. Methods Two-centimeter-wide strips of macroporous polypropylene mesh were passed through the abdominal wall and tied as simple interrupted sutures to achieve umbilical hernia repair. A retrospective review of all elective umbilical hernia repairs performed by a single surgeon using the mesh strip technique between 2016 and 2021 was conducted, and patient-reported outcomes were assessed via a telephonic survey. Results Thirty-three patients underwent an elective, open mesh strip repair of a primary umbilical hernia and met criteria for inclusion in the study. Of these patients, 60% responded to a patient-reported outcomes telephone survey. Ninety percent of survey responders reported a pain score of 0 of 10. Additionally, 90% reported being unable to feel or palpate the knot, and 80% reported an improvement in quality of life. Mean follow-up at 3 years revealed one recurrence in the setting of ascites, yielding a recurrence rate of 3%. Conclusion Primary mesh strip repair of umbilical hernias combines the simplicity of suture repair with the advantageous force distribution properties of mesh, and constitutes a safe, efficient, and effective method of repair with a low recurrence rate at long-term follow-up that is comparable to planar mesh repair.
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Affiliation(s)
- Simon Moradian
- From the Department of Surgery, Division of Plastic Surgery, Northwestern Feinberg School of Medicine, Chicago, Ill
| | - Julian L. Klosowiak
- From the Department of Surgery, Division of Plastic Surgery, Northwestern Feinberg School of Medicine, Chicago, Ill
| | - Michael J. Boctor
- From the Department of Surgery, Division of Plastic Surgery, Northwestern Feinberg School of Medicine, Chicago, Ill
| | - Tariq Issa
- From the Department of Surgery, Division of Plastic Surgery, Northwestern Feinberg School of Medicine, Chicago, Ill
| | - Seong Park
- From the Department of Surgery, Division of Plastic Surgery, Northwestern Feinberg School of Medicine, Chicago, Ill
| | - Gregory A. Dumanian
- From the Department of Surgery, Division of Plastic Surgery, Northwestern Feinberg School of Medicine, Chicago, Ill
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Olsson A, Woxnerud K, Kiwanuka O, Sandblom G, Stackelberg O. The TOR concept (training, operation, and rehabilitation) applied to a cohort of postpartum women with training-resistant symptomatic rectus diastasis: evaluation 1 year after surgery. BJS Open 2023; 7:7025466. [PMID: 36734959 PMCID: PMC9897176 DOI: 10.1093/bjsopen/zrac162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/13/2022] [Accepted: 11/07/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Rectus diastasis is a common sequela of pregnancy and is associated with functional disabilities such as back pain, abdominal core instability, abdominal muscle weakness, urinary incontinence, and psychological issues such as a negative body image. The aim of this study was to evaluate the effect of the TOR concept (training, operation, and rehabilitation), a novel concept for treating abdominal wall insufficiency combined with rectus diastasis, after pregnancy. TOR consists of preoperative evaluation of symptoms and custom-designed abdominal core training, tailored rectus diastasis repair, and individual progressive postoperative rehabilitation. METHODS A consecutive series of women diagnosed with rectus diastasis and core dysfunction resistant to training, underwent plication of the linea alba between 2018 and 2020. After surgery, all patients participated in an individually designed rehabilitation programme over a 4-month interval. Physical function was recorded before surgery and 1 year after surgery using the disability rating index questionnaire. Symptoms associated with core instability were recorded before and 1 year after surgery. Quality of life was assessed using the SF-36. The abdominal wall anatomy was assessed with ultrasound before and 1 year after surgery. RESULTS Seventy-one women were included and all attended 1-year follow-up. Response rate was 81.7 per cent (58) for the disability rating index, and 59.2 per cent (42) for SF-36. Self-reported physical function (disability rating index) improved in 54 of 58 patients (93.1 per cent), with a median score reduction of 91.3 per cent. Core instability symptoms decreased significantly. All SF-36 subscales improved significantly compared with preoperative scores, reaching levels similar to or higher than the normative Swedish female population. No recurrence of rectus diastasis was seen at the 1-year follow-up. CONCLUSIONS Surgical reconstruction within the TOR concept resulted in significant improvements in physical function and quality of life as well as a significant decrease in symptoms of core instability.
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Affiliation(s)
- A Olsson
- Correspondence to: Anders Olsson, PhD, Department of Clinical Science and Education and Department of Surgery, Södersjukhuset, Sjukhusbacken 10, 118 83 Stockholm, Sweden (e-mail: )
| | - K Woxnerud
- Stockholm Hernia Center, Stockholm, Sweden,Women's Health Department, Hela Kvinnans Klinik, Stockholm, Sweden
| | - O Kiwanuka
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden,Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - G Sandblom
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden,Department of Surgery, Södersjukhuset, Stockholm, Sweden
| | - O Stackelberg
- Department of Clinical Science and Education, Karolinska Institute, Södersjukhuset, Stockholm, Sweden,Department of Surgery, Södersjukhuset, Stockholm, Sweden,Unit of Nutritional Epidemiology, Karolinska Institute, Institute of Environmental Medicine, Stockholm, Sweden
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Open Versus Laparoscopic Surgical Management of Rectus Diastasis: Systematic Review and Pooled Analysis of Complications and Recurrence Rates. World J Surg 2022; 46:1878-1885. [DOI: 10.1007/s00268-022-06550-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2022] [Indexed: 10/18/2022]
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10
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Dumanian GA, Moradian S. Mesh abdominoplasty for rectus diastasis in women and men. Hernia 2021; 25:863-870. [PMID: 34342745 PMCID: PMC8370955 DOI: 10.1007/s10029-021-02461-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/16/2021] [Indexed: 02/05/2023]
Abstract
Purpose Meshes clearly have improved outcomes for tissue approximation over suture repairs for incisional hernias. A knowledge gap exists as to the surgical complication rate and post-operative outcomes of a mesh rectus diastasis repair with a narrow well-fixed mesh that simultaneously narrows the rectus muscles and closes the widened linea alba. Methods Inclusion criteria for mesh abdominoplasty were patients who (1) underwent a retrorectus planar mesh for repair of rectus diastasis (2) did not have a concurrent incisional hernia and (3) underwent skin tailoring as part of a cosmetic aspect of their care. The primary endpoint was surgical site occurrence (SSO) at any time after surgery as determined with review of their office and hospital medical records. Secondary endpoints included the length and complexity of the return to the operating room for any reason, non-surgical complications, readmission, post-operative recovery, surgical site infection, recurrence/persistence of abdominal wall laxity, and soft tissue revision rates. Results SSO rate was 0% for the 56 patients who underwent this procedure. There were 40 women and 16 men. Superficial infections requiring oral antibiotics were required in three patients. One was a drain site erythema, one was for a superficial stitch abscess, and the third was for a mesh strip knot infection 6 months after the procedure. One patient underwent further tightening of the abdominal wall. Rates of soft tissue revision in the office for improved cosmesis were 23% in women and 6% in men. Conclusion Repair of rectus diastasis with a narrow well-fixed mesh and concurrent skin abdominoplasty is a well-tolerated and reliable procedure with low recurrence and low SSO in the manner described. It is a procedure that works for both female and male pattern rectus diastasis, and has become our procedure of choice for moderate and severe rectus diastasis. Supplementary Information The online version contains supplementary material available at 10.1007/s10029-021-02461-1.
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Affiliation(s)
- G A Dumanian
- Division of Plastic Surgery, Department of Surgery, Northwestern Feinberg School of Medicine, 675 N St. Clair, Suite 19-250, Chicago, IL, 60611, USA.
| | - S Moradian
- Division of Plastic Surgery, Department of Surgery, Northwestern Feinberg School of Medicine, 675 N St. Clair, Suite 19-250, Chicago, IL, 60611, USA
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