Our Summary

Diastasis recti is a condition where the two large parallel bands of muscles that meet in the middle of the abdomen separate. This can impact not only the stomach area but also the muscles supporting the lower back and pelvis, which can disrupt urinary and digestive functions. A surgical method called preaponeurotic endoscopic repair (REPA) is an alternative to a tummy tuck for treating this condition.

In this study, a single surgeon performed REPA on 172 patients from August 2017 to December 2019. Out of these, 124 were tracked for at least a year, and 63 responded to a survey about their satisfaction and quality of life a year after the surgery.

Three patients (2.4%) had the condition reoccur, with one patient experiencing it twice. After surgery, some patients experienced complications like fluid-filled pockets (seromas), blood-filled swellings (haematomas), one case of infection, some developed skin fold, and one had a skin lesion that needed additional treatment. However, the 63 patients who responded to the survey reported being satisfied with their life post-surgery.

The study concludes that REPA is a safe and effective treatment for diastasis recti and is a good alternative to a tummy tuck. It does not require accessing the abdominal cavity and the repair mesh is applied on the surface, reducing the risk of damage to the intestines or adhesions between the intestines and the repair material.

FAQs

  1. What is preaponeurotic endoscopic repair (REPA) and how does it help in the treatment of diastasis recti?
  2. What were the outcomes and complications observed in the study of REPA application for diastasis recti treatment?
  3. How does REPA compare to abdominoplasty in the treatment of diastasis recti?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tummy tuck or diastasis recti repair surgery is to follow postoperative care instructions carefully to reduce the risk of complications such as seromas, hematomas, or infections. It is also important to maintain a healthy lifestyle, including regular exercise and proper nutrition, to optimize the results of the surgery and improve overall quality of life. Additionally, patients should communicate any concerns or symptoms to their doctor promptly to ensure proper healing and successful outcomes.

Suitable For

Patients who are typically recommended for a tummy tuck, or in this case, preaponeurotic endoscopic repair (REPA) for the treatment of diastasis recti, may include those who have:

  1. Diastasis recti: This is a condition where the abdominal muscles separate, leading to a protruding belly and weakened core muscles.

  2. Abdominal wall defects: Patients with defects in the abdominal wall, such as hernias or muscle weakness, may benefit from a tummy tuck procedure.

  3. Lumbopelvic muscle instability: Patients with instability in the muscles of the lower back and pelvis may benefit from a tummy tuck to improve core strength and stability.

  4. Urinary and digestive functionality issues: Patients experiencing urinary or digestive problems related to diastasis recti may benefit from a tummy tuck to improve these functions.

Overall, patients who are looking to improve the appearance and function of their abdominal area, particularly those with diastasis recti or other abdominal wall defects, may be recommended for a tummy tuck procedure like REPA.

Timeline

Before tummy tuck:

  • Patient experiences diastasis recti, a condition affecting the abdominal wall and lumbopelvic muscles
  • Patient may have urinary and digestive functionality issues
  • Patient undergoes consultation with a surgeon to discuss treatment options
  • Patient decides to undergo preaponeurotic endoscopic repair (REPA) as an alternative to tummy tuck

After tummy tuck:

  • Surgery is performed between August 2017 and December 2019
  • 172 patients undergo REPA for diastasis recti treatment
  • 124 patients are followed for at least one year post-surgery
  • 3 (2.4%) recurrences occur, with main complications including seromas, hematomas, and skin fold formation
  • Quality of life after surgery is reported as satisfactory by 63 patients who respond to a survey
  • REPA is deemed a safe and effective technique for diastasis recti treatment, with no risks of bowel damage or adhesions between the intestine and prosthesis.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a tummy tuck procedure?
  2. How long is the recovery period after a tummy tuck surgery?
  3. Will I need to follow a specific diet or exercise plan before or after the surgery?
  4. What type of anesthesia will be used during the procedure?
  5. How long do the results of a tummy tuck typically last?
  6. Can I see before and after photos of patients who have undergone a tummy tuck with this surgeon?
  7. Will I have visible scarring after the surgery, and if so, how can it be minimized?
  8. Are there any lifestyle changes I should make before or after the surgery to optimize results?
  9. How soon after the surgery can I resume normal activities, such as exercise or work?
  10. What post-operative care will be required, and what should I do if I experience any complications or concerns?

Reference

Authors: Cuccomarino S, Bonomo LD, Aprà F, Toscano A, Jannaci A. Journal: Surg Endosc. 2022 Feb;36(2):1302-1309. doi: 10.1007/s00464-021-08405-1. Epub 2021 Mar 4. PMID: 33661382