BACKGROUND: Recurrent rectus diastasis is a troublesome complication because its correction requires an extensive procedure. CASE REPORTS: Two patients with recurrent rectus diastasis secondary to abdominoplasty corrected by plication of the anterior rectus sheath are presented. These patients had lateral insertion of the rectus muscles. They were treated by the advancement of the rectus muscles after undermining of the posterior rectus sheath and a two-layer closure to correct the rectus diastasis. Good cosmetic results and postoperative pain control were achieved in both cases. DISCUSSION: The causes, prevention, and treatment for this type of rectus diastasis are described. The main reason for recurrence of this deformity in these patients was lateral insertion of the rectus muscles on the costal margins. On the basis principle, an efficient technique to correct this deformity is described. A postoperative compute tomography scan with slices made at the same bony level as the preoperative control examination demonstrated total correction of rectus diastasis over a long-term follow-up evaluation. CONCLUSION: Advancement of the recti muscles seems to be a reliable method for correcting recurrent rectus diastasis in patients with lateral insertion of the recti muscles.
BACKGROUND: Recurrent rectus diastasis is a troublesome complication because its correction requires an extensive procedure. CASE REPORTS: Two patients with recurrent rectus diastasis secondary to abdominoplasty corrected by plication of the anterior rectus sheath are presented. These patients had lateral insertion of the rectus muscles. They were treated by the advancement of the rectus muscles after undermining of the posterior rectus sheath and a two-layer closure to correct the rectus diastasis. Good cosmetic results and postoperative pain control were achieved in both cases. DISCUSSION: The causes, prevention, and treatment for this type of rectus diastasis are described. The main reason for recurrence of this deformity in these patients was lateral insertion of the rectus muscles on the costal margins. On the basis principle, an efficient technique to correct this deformity is described. A postoperative compute tomography scan with slices made at the same bony level as the preoperative control examination demonstrated total correction of rectus diastasis over a long-term follow-up evaluation. CONCLUSION: Advancement of the recti muscles seems to be a reliable method for correcting recurrent rectus diastasis in patients with lateral insertion of the recti muscles.
Authors: Elwin H H Mommers; Jeroen E H Ponten; Aminah K Al Omar; Tammo S de Vries Reilingh; Nicole D Bouvy; Simon W Nienhuijs Journal: Surg Endosc Date: 2017-06-08 Impact factor: 4.584