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Minerva Chirurgica 2020 Aug 06

DOI: 10.23736/S0026-4733.20.08404-7


lingua: Inglese

Laparoscopic diastasis recti abdominis and midline hernia repair

Giuseppe BARBATO 1 , Silvia ROLLO 1, Cristina MAGGIONI 1, Fabio CIANCHI 1, Francesco CORATTI 2

1 Azienda Ospedaliero-Universitaria Careggil, University of Florence, Florence, Italy; 2 Division of Gastrointestinal Surgery, Careggi University Hospital, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy


BACKGROUND: Diastasis Recti Abdominis DRA is defined as an abnormally wide distance separates the two rectus muscles. Thinning and widening of the linea alba is an important risk factor for development midline hernia. In patient with DRA there is an increase rate of hernia recurrence.
METHODS: We perform a retrospective study to assess the outcome of laparoscopic intraperitoneal hernia repair and linea alba plication combined with mesh placement to obtain an adequate overlap of midline hernia associated to an abdominal wall support. The inclusion criteria were patients who has a clinical diagnosis of primary midline hernias of any size with associated diastasis recti. The exclusion criteria were incisional hernias, hernias outside of the midline. A total of 12 patients fulfilled the inclusion criteria. No complication was observed over the follow up period. The rates for recurrence were 0% over the follow up period.
RESULTS: Despite the limited data some assumptions can be drawn from this study. The presence of DRA and coexisting hernia involves a challenging choice of the surgical treatment. Whichever approach is taken, in order to achieve an effective correction, plication of the linea alba is required. The major goal of any abdominal wall repair is not only reduction of hernia sac and prevention of further herniation but also restoration of the integrity and restitution of abdominal wall functionality.
CONCLUSIONS: A laparoscopic approach to midline hernias associated to DRA is feasible and reproducible. It is necessary future prospective studies on larger numbers to improve knowledge on the management of DRA.

KEY WORDS: Diastasis recti abdominis; Midline hernia; Laparoscopic hernia surgery

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