Everything you need to know about diastasis recti repair surgery

Diastasis recti repair surgery is a procedure designed to correct the separation of abdominal muscles, a common condition after pregnancy or for other causes. This type of surgery helps restore muscle function and improves core abdominal stability, which can reduce the pain and weakness that many people experience. In addition, it can offer aesthetic benefits by regaining abdominal shape.

Before surgery, it is important that the patient receive a full evaluation to determine the severity of the diastasis and rule out other complications. There are several surgical techniques, from open to laparoscopic methods, which can be adapted according to individual needs. Recovery requires specific care to ensure lasting results and improve quality of life.

Key points

• Surgery improves muscle function and abdominal stability.
• La prior evaluation is essential for a proper surgical plan.
• Recovery influences the long-term success of the procedure.

What is rectus abdominis diastasis?

Rectus abdominal diastasis is the abnormal separation of the rectus abdominal muscles, which are the two vertical muscles that run along the front of the torso. This condition affects the function and structure of the abdomen, and can cause muscle weakness and postural problems. It is usually related to changes in pressure within the abdomen and the condition of the connective tissue.

Common Causes of Rectal Diastasis

The main cause of rectum diastasis is the overstretching of the connective tissue that attaches to the rectus abdominal muscles. This stretch occurs when intra-abdominal pressure increases, for example, during pregnancy, or with abdominal obesity. It also affects people who carry out inadequate weight lifting and those who suffer from chronic constipation or prolonged coughing.

Factors such as age, genetics, and connective tissue weakness can increase the chance of developing diastasis. In some cases, pressure can even cause an umbilical hernia.

Symptoms and associated consequences

Symptoms include a visible bulge in the midline of the abdomen, especially when straining. Weak abdominal muscles cause poor posture and lower back or lower back pain.

In addition, diastasis can cause functional problems such as urinary incontinence and pelvic organ prolapse due to low core body support. Abdominal weakening can also cause constipation and a feeling of bloating or bloating.

Relationship with pregnancy and abdominal changes

Pregnancy is one of the most common causes of rectal diastasis. During pregnancy, the growing uterus increases internal pressure, stretching the alba line that connects the rectus muscles. This happens to accommodate the baby, but sometimes the separation doesn't close after delivery.

Hormonal changes that affect the elasticity of connective tissue contribute to this weakness. Postpartum diastasis can cause abdominal sagging and increase the risk of low back pain and posture problems if not treated properly.

Evaluation and diagnosis before surgery

The correct identification and evaluation of rectus abdominal muscle diastasis is essential for planning surgical repair. In addition, it is key to define when surgery is necessary and to detect any associated complications, such as umbilical hernias, that may influence treatment.

How to identify diastasis recti

Diastasis recti is identified by an abnormal separation of the rectus abdominal muscles, usually when the distance between them exceeds 2 cm. This separation can be detected by physical examination, palpating the abdominal midline while the patient makes an effort, such as lifting the head or flexing the trunk.

It is also possible to use ultrasound or tomography to accurately measure the distance and evaluate the connective tissue involved. Diastasis is common after pregnancy or in people with increased abdominal pressure.

Clinical Criteria for Surgical Repair

Surgery is recommended when the gap is greater than 4 cm and causes significant symptoms, such as abdominal pain, muscle weakness, or functional problems. The presence of a visible bulge that affects aesthetics or causes discomfort may also be a valid criterion.

Repair should be considered if the diastasis is associated with an umbilical hernia or other midline defects. The surgical decision depends on the size, symptoms and failure of conservative treatments such as physical therapy.

Evaluation of associated complications

Diastasis recti is often accompanied by umbilical hernias, which are protuberances due to weakness in the alba line. These can increase the risk of complications and need to be detected before surgery.

The integrity of the linea alba and the presence of weakened tissues or previous scarring should be evaluated. Preoperative evaluation includes imaging studies to rule out hidden defects and plan an appropriate surgical approach that includes simultaneous repair of hernias if they exist.

Diastasis Recti Repair Surgery: Options and Techniques

Rectal diastasis repair can be performed using different methods depending on the extent of the damage and the patient's condition. The techniques range from directly connecting muscles to using meshes to strengthen the abdominal wall. Each technique has advantages and limitations in terms of recovery, aesthetic and functional results.

Abdominoplasty and muscle plication

Abdominoplasty, also called Tummy Tuck, is a technique that combines the removal of excess skin with muscle repair. Muscle plication involves suturing the straight muscles to bring them closer together and restore the alba line. This technique is performed through a large incision in the abdomen.

It is especially useful in patients with loose skin and marked diastasis. The suture in the plicature is done manually to maintain adequate tension and improve abdominal wall strength. Although recovery may be slower, the result includes better abdominal circumference and reduced volume.

Postoperative recovery, results and recommendations

Recovery after rectal diastasis surgery requires attention to the healing phases and rigorous medical follow-up. The process may vary depending on the type of intervention and the patient's individual response. The proper integration of core exercises and physical therapy is key to avoiding discomfort such as low back pain or constipation.

Expectations for recovery after surgery

After surgery, the patient will experience discomfort and should avoid heavy physical exertion, especially for the first two weeks. Relative rest and the use of an abdominal girdle help reduce inflammation and protect the suture line.

Between 2 and 6 weeks, activity can increase progressively, always without lifting weight or doing sit-ups. Rejoining daily tasks without physical effort is usually possible during this time, while strenuous exercise or weight lifting should be avoided until after 8 to 12 weeks.

During recovery, discomfort in the abdomen or lower back is common. Maintaining a diet rich in fiber and good hydration prevents constipation, which can impair healing.

Risks and possible complications

The main postoperative risk is wound infection, which can be minimized by following strict medical indications. Excessive swelling or bruising may also occur.

Another possible complication is the recurrence of the problem if early physical effort is made or abdominal pressure is increased due to constipation or overweight.

Low back pain can be prolonged if the core muscles are not properly corrected. This is why it is crucial to avoid heavy lifting and sudden movements during recovery.

Importance of core exercises and physical therapy

Physical therapy plays an essential role in strengthening the abdominal wall without putting pressure on the scar. Hypopressive exercises and pelvic floor work are recommended to safely strengthen the core.

These exercises help improve posture and reduce discomfort such as low back pain or a feeling of a bloated abdomen. Muscle re-education is gradual and must be supervised to avoid undue loads.

Incorporating diaphragmatic breathing and postural control exercises slowly improves core function and supports full recovery without causing complications.

Frequently Asked Questions

Surgery to repair rectal diastasis can have side effects, and recovery time varies from patient to patient. There are ways to manage costs and some exercise recommendations that can improve the condition without the need for surgery.

What are the side effects of rectal diastasis repair surgery?

Common side effects include swelling, pain in the operated area, and possible bruising. In some cases, there may be altered skin sensitivity or visible scarring. Rare complications can include infections or problems with healing, but these are rare when the surgery is done correctly.

What is the recovery time after rectal diastasis repair surgery?

The initial recovery usually lasts between two and six weeks. During this time, patients should avoid strenuous physical activity to allow muscles to heal well. Full recovery for normal activities and exercise may take up to three months or longer, depending on the extent of the surgery.

How can I get my insurance to cover rectal diastasis repair surgery?

Generally, health insurance only covers surgery if diastasis causes serious functional problems, such as severe pain or hernias. It is important to obtain a clear diagnosis and medical documentation that explains the medical need. Consulting directly with the insurance provider and the surgeon helps to understand what tests and reports are necessary for approval.

Are there recommended exercises to improve rectal diastasis without surgery?

Some gentle exercises can strengthen the abdominal muscles and help in mild cases. They should be done carefully and preferably under the supervision of a physical therapist.

Inadequate exercises can worsen the separation, so trying without professional guidance is not recommended.

How does laparoscopic surgery for rectal diastasis compare to traditional tummy tuck?

Laparoscopic surgery is less invasive, with smaller incisions and generally less recovery time. However, it is not always suitable for all cases, especially if there is a lot of excess skin. Traditional tummy tuck corrects both diastasis and removes excess skin for better aesthetic results.

Is it possible to repair rectal diastasis during hernia surgery?

Yes, in many cases diastasis repair can be done in conjunction with abdominal hernia surgery. This optimizes recovery and improves the function and appearance of the abdominal wall. The surgeon will evaluate whether both conditions can be safely treated at the same time on a case-by-case basis.

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