Totally endoscopic surgery on diastasis recti associated with midline hernias. The advantages of a minimally invasive approach. Prospective cohort study

Luque, Juan Bellido; Luque, A Bellido; Valdivia, Javier; Grau, J. M. Suárez; Menchero, J Gómez; Moreno, Joaquín García; Jurado, Juan Guadalajara

doi:10.1007/s10029-014-1300-2

Cited by 102 publications

(83 citation statements)

References 15 publications

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“…The literature is limited. Six studies were identified: three prospective cohort and three retrospective studies.…”

Section: Resultsmentioning

confidence: 99%

“…Endoscopic repair with plication of the diastasis using a non‐absorbable loop suture followed by an onlay or preperitoneal polypropylene mesh was performed of the midline hernia and the coexisting rectus diastasis in three studies. The studies of Köckerling and colleagues and Claus et al .…”

Section: Resultsmentioning

confidence: 99%

“…The studies of Köckerling and colleagues and Claus et al . included both incisional and primary ventral hernias, and Bellido Luque and co‐workers included solely primary ventral hernias. Follow‐up was 20 months, 8 months and 1 year respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Follow‐up was 2–8 years and mean 15 months, with no recurrences or bulging. A retrospective cohort study described an open technique with self‐fixating mesh in the preperitoneal space extending superiorly including the umbilical hernia, with no wound complications but one hernia recurrence in 58 patients.…”

Section: Resultsmentioning

confidence: 99%

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EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

et al. 2020

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Background Rare locations of hernias, as well as primary ventral hernias under certain circumstances (cirrhosis, dialysis, rectus diastasis, subsequent pregnancy), might be technically challenging. The aim was to identify situations where the treatment strategy might deviate from routine management. Methods The guideline group consisted of surgeons from the European and Americas Hernia Societies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used in formulating the recommendations. The Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklists were used to evaluate the quality of full‐text papers. A systematic literature search was performed on 1 May 2018 and updated 1 February 2019. The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was followed. Results Literature was limited in quantity and quality. A majority of the recommendations were graded as weak, based on low quality of evidence. In patients with cirrhosis or on dialysis, a preperitoneal mesh repair is suggested. Subsequent pregnancy is a risk factor for recurrence. Repair should be postponed until after the last pregnancy. For patients with a concomitant rectus diastasis or those with a Spigelian or lumbar hernia, no recommendation could be made for treatment strategy owing to lack of evidence. Conclusion This is the first European and American guideline on the treatment of umbilical and epigastric hernias in patients with special conditions, including Spigelian and lumbar hernias. All recommendations were weak owing to a lack of evidence. Further studies are needed on patients with rectus diastasis, Spigelian and lumbar hernias.

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“…The literature is limited. Six studies were identified: three prospective cohort and three retrospective studies.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

et al. 2020

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“…If RAD is symptomatic or associated with midline hernias (umbilical, trocar and/or epigastric), corrective surgery of all pathologies at the same time could represent the most recommended approach [3]. …”

Section: Introductionmentioning

confidence: 99%

Endoscopic-assisted linea alba reconstruction

et al. 2017

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SummaryBackgroundPatients with symptomatic umbilical, trocar, and/or epigastric hernias and concomitant rectus abdominis diastasis represent a growing clinical problem. The optimal management of this complex hernia situation is the subject of debate in the literature. This paper reports the early results of an innovative surgical technique aimed at managing this hernia situation.MethodsEndoscopic-assisted linea alba reconstruction (ELAR) with mesh augmentation is a surgical technique long known in the literature for its good outcome for incisional hernia repair (myofascial release, overlapping herniorrhaphy, Gibson’s operation, shoelace repair, anterior rectus sheath repair, dynamic patch plasty) via a small access route. The early results for 140 patients are presented here.ResultsTwo patients (1.4%) developed postoperative complications requiring redo surgery. These were two cases of diffuse secondary bleeding without an identifiable bleeding source, in one patient with liver cirrhosis and portal hypertension and in another patient receiving treatment with platelet aggregation inhibitors. All other complications were successively managed with conservative treatment. After 1 year, two of 30 patients reported occasional pain, including pain at rest in one patient.ConclusionThe ELAR technique with mesh augmentation is an innovative, minimally invasive surgical procedure for treatment of patients with a complex abdominal wall hernia comprising symptomatic umbilical, trocar, and/or epigastric hernias with concomitant rectus abdominis diastasis.

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Endoscopic Diastasis Recti Plication

Bellido-Luque,

Bascuas-Rodrigo

2023

Post-Maternity Body Changes

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Totally endoscopic surgery on diastasis recti associated with midline hernias. The advantages of a minimally invasive approach. Prospective cohort study

Cited by 102 publications

References 15 publications

EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

Endoscopic-assisted linea alba reconstruction

Endoscopic Diastasis Recti Plication

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