Closing the gap: evidence-based surgical treatment of rectus diastasis associated with abdominal wall hernias

Purpose Rectus diastasis (RD) associated with abdominal hernias present a surgical challenge associated with a paucity in treatment guidelines. The objective of this systematic review is to review surgical techniques and assess complication and recurrence rates of RD in patients with concurrent abdo...

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Bibliographic Details
Published in:Hernia : the journal of hernias and abdominal wall surgery 2021-08, Vol.25 (4), p.827-853
Main Authors: ElHawary, H., Barone, N., Zammit, D., Janis, J. E.
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Surgery
Abdominal wall
Dehiscence
DIASTASIS RECTI
Hematoma
Hernias
Laparoscopy
Medicine
Medicine & Public Health
Minimally invasive surgery
Patients
Review
Surgery
Surgical mesh
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Summary:Purpose Rectus diastasis (RD) associated with abdominal hernias present a surgical challenge associated with a paucity in treatment guidelines. The objective of this systematic review is to review surgical techniques and assess complication and recurrence rates of RD in patients with concurrent abdominal hernias. Methods PubMed and EMBASE databases were systematically searched, and data extraction was performed on articles which met the inclusion criteria. Pooled analyses of complication and recurrence rates were performed to compare open vs. minimally invasive surgery. Student t tests were performed to compare differences in continuous outcomes. Results Twenty-eight studies were included in this review. RD can be surgically repaired by both open and laparoscopic approaches using both non-absorbable and absorbable sutures. The majority of the techniques reported included mesh insertion either above the aponeurosis, retromuscular, preperitoneal, or intraperitoneal. Open techniques, compared to laparoscopic approaches, were associated with a significantly higher rate of skin dehiscence (6.79% vs. 2.86%; p  = 0.003) and hematoma formation (4.73% vs. 1.09%; p  
ISSN:1265-4906
1248-9204
DOI:10.1007/s10029-021-02460-2