Contemporary imaging of rectus diastasis and the abdominal wall

Hernia ◽  
2021 ◽  
Author(s):  
A. A. Plumb ◽  
A. C. J. Windsor ◽  
D. Ross
Keyword(s):  
Abdominal Wall ◽  
Rectus Diastasis

Abdominal Wall Reconstruction

2018 ◽  
Author(s):  
Gregory A. Dumanian
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Abdominal Wall Defects ◽  
Gap Formation ◽  
Rectus Diastasis ◽  
Dramatic Form ◽  
Tensile Forces ◽  
Surgical Failure ◽  
Pull Through ◽  
Abdominal Shape

The closure of the abdominal wall defects is a fascinating field within surgery. The combined strength of sutures and scar after simple approximation of tissues in many cases does not suffice to contain the abdominal viscera and an incisional hernia results. Surgical failure can be seen immediately in the dramatic form of a dehiscence or can emerge slowly over time with a change in the abdominal shape and contour. This chapter delves into the theory and practicum of how a surgeon can approximate two halves of an abdominal wall together to resist the inherent tensile forces that exist and create a durable closure. This review contains 19 figures and 35 references Key Words: bioprosthetic, bridging, component release, force distribution, foreign body reaction, gap formation, hernia, laparotomy, mesh, perforator preservation, rectus diastasis, suture pull-through, TAR release

scholarly journals Mesh abdominoplasty for rectus diastasis in women and men

Hernia ◽  
2021 ◽  
Author(s):  
G. A. Dumanian ◽  
S. Moradian
Keyword(s):  
Soft Tissue ◽  
Abdominal Wall ◽  
Surgical Complication ◽  
Linea Alba ◽  
Operative Outcomes ◽  
Rectus Diastasis ◽  
Secondary Endpoints ◽  
Tissue Approximation ◽  
Stitch Abscess ◽  
Operative Recovery

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.

scholarly journals A Case of Malformation of the Liver Complicated with Cholelithiasis and Rectus Diastasis of the Abdominal Wall

Kanzo ◽  
1978 ◽  
Vol 19 (8) ◽  
pp. 796-802
Author(s):  
Masataka IWASAKI ◽  
Eisuke NAGATA ◽  
Hirohiko ABE ◽  
Kyuichi TANIKAWA ◽  
Teru NAKAMURA ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Rectus Diastasis

scholarly journals ABDOMINAL RECTUS DIASTASIS (ARD) CORRECTION FOR PAIN REDUCTION AND IMPROVEMENT OF ABDOMINAL WALL MUSCLE STRENGTH

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Kaustubh Vasant Waikar
Keyword(s):  
Muscle Strength ◽  
Abdominal Wall ◽  
Training Group ◽  
Rectus Abdominis ◽  
Operative Repair ◽  
Rectus Diastasis ◽  
Wall Strength ◽  
Collagen Iii ◽  
Mesh Augmentation ◽  
Computed Tomography Scanning

Introduction: Rectus abdominis diastasis (RAD) can be described as a condition in which rectus abdominis muscles are separated by an abnormally wide distance i.e. any separation of more than 2 cm is considered to be abnormal. Several aetiological factors may lead to protrusion of the anterior abdominal wall. It is a common complaint in women after childbirth. Abdominal rectus diastasis (ARD) is a sequele of the expansion of the abdominal contents during pregnancy or massive weight loss and/or congenital disproportion of the collagen III/I ratio. Operative repair of ARD can improve abdominal wall function. Various methods for ARD repair have been described. These differ by approach like open versus laparoscopic, the position of suture placement, numbers of layers of sutures, suture material, and use of mesh. Also it can be combined with mesh augmentation in the IPOM technique for enhanced stabilization of the abdominal wall. Material and Methods:  Eligible patients were randomized to either one of two operative procedures or a 3-month, dedicated training program which serve as a control group. ARD width was assessed clinically and confirmed with computed tomography scanning. Endpoints were assessed after 6 months for relapse of the ARD, pain, restriction of daily activities and improvement in muscle strength. Abdominal wall strengthe was assessed by Visual analogue scale (VAS). Results: A total of 72 patients were enrolled into the study (70 female and 2 male). 24 patients were enrolled in each group. 13 patients had undergone cesarean section in the Quill group and 12 in the mesh group. According to VAS scale no statistically significant difference was seen between the two operative groups regarding perceived improvement in abdominal wall strength. But it was significantly higher in operated group as compared to training group. Abdominal muscular strength was improved in all the three groups. Improvement in abdominal wall strength was lower in training group compared to operative groups. No relapse was observed in operative groups. Conclusion: Operative repair of ARD can provide functional stability and improvement in pain and physical parameters it also improves quality of life, and reduce functional disability. Keywords: ARD, Quill SRS, Mesh repair, VAS, linea alba (LA)

scholarly journals Intra abdominal pressure changes in meshplasty and abdominal wall plication techniques in abdominoplasty: a comparative study

2021 ◽  
Vol 8 (11) ◽  
pp. 3370
Author(s):  
Ramya Thulaseedharan Pillai ◽  
Varghese Joseph ◽  
Krishnakumar Marar
Keyword(s):  
Comparative Study ◽  
Abdominal Wall ◽  
Symptomatic Treatment ◽  
Study Groups ◽  
Abdominal Pressure ◽  
Rectus Diastasis ◽  
Abdominal Hypertension ◽  
Soft Tissue Laxity ◽  
Patients At Risk ◽  
Pressure Changes

Background: Measurement of intra abdominal pressures is used to identify patients at risk of intra-abdominal hypertension and abdominal compartment syndrome after abdominoplasty that may lead to tight closure of the abdomen. This comparative study was aimed at measuring the IAP of patients in groups of meshplasty and abdominal wall plication, intraoperatively and post operatively.Methods: A comparative study was conducted among 34 patients who underwent meshplasty and abdominal wall plication. Each group comprised of 17 patients. All preoperative blood investigations and pre anesthetic evaluations were done. The technique used is decided based on the soft tissue laxity, rectus diastasis and presence of ventral hernias. Intra operatively, IAP was measured soon after the placement of mesh or after Rectus plication and post operatively, IAP was measured within 24 hours. IAP was measured using the intra vesical technique using Foley’s Catheter.Results: Fifty percent of the total patients were in the age group 41-50yrs and 88.2% of the patients were females. No significant variations in IAP, either intraoperative (p=0.051) or post operative (p=0.202), was evidenced in both groups. Post operatively, patient developed minimal complications such as seroma collection, wound infection and respiratory complications, improving on symptomatic treatment and antibiotics.Conclusions: No significant intraoperative or postoperative IAP was found between the two study groups underwent meshplasty and abdominal wall placation techniques.

scholarly journals Efficiency assessment of laparoscopic vs open alloplasty for incisional ventral hernias

2021 ◽  
Vol 11 (5) ◽  
pp. 223-228
Author(s):  
Ya. P. Feleshtynsky ◽  
O. M. Lerchuk ◽  
V. V. Smishchuk
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Wall Defect ◽  
Efficiency Assessment ◽  
Rectus Diastasis ◽  
Group I ◽  
Laparoscopic Hernioplasty ◽  
Mesh Implant ◽  
Ventral Hernias

Materials and methods. During the period from 2009 to 2020 in the clinic of the Department of Surgery and Proctology of the Shupyk National Healthcare University of Ukraine, the surgical treatment of 217 patients with IVH was analysed.The choice of laparoscopic hernioplasty or open allohernioplasty was made taking into account the size of the abdominal wall defect and the width of the rectus diastasis. By intraoperatively conducting a study during a surgery for IVH with an abdominal rectus diastasis involving approximation of the rectus muscles and measurement of IAP, it was found that with an abdominal rectus diastasis measuring up to 5 cm IAP increases to 5.6 ± 1.3 mm Hg and the abdominal wall defect is closed without an undue tension of the supporting tissues.Depending on the method of surgical treatment, patients were divided into 2 groups.In group I, 109 (21.5%) patients with small and medium-sized IVH with a diastasis of up to 5 cm underwent laparoscopic allohernioplasty, in particular, 63 patients underwent laparoscopic preperitoneal alloplasty and 46 underwent laparoscopic retromuscular alloplasty.Conclusions. For small and medium-sized IVH with an abdominal rectus diastasis of up to 5 cm, laparoscopic allohernioplasty with preperitoneal and retromuscular placement of the mesh implant and elimination of the diastasis is optimal. In comparison with open retromuscular allohernioplasty, it contributes to a significant reduction in the incidence of seroma (from 35.2% to 3.7%), postoperative wound suppuration (from 6.5% to 0%), inflammatory infiltrate (from 4.6% to 0%), chronic postoperative pain (from 6.4% to 2.6%), and recurrence of hernia (from 6.4% to 0%).

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