La abdominal diastasis consists in a separation of rectus abdominis musclesthe two long central abdominal muscles. Very frequently due to the pregnancyirreversibly affects about one third of women who have given birth; in theman, the abdominal diastasis may appear in connection with, for example, weight gain or intense physical exertion.
Just an aesthetic problem?
Normally, the rectus abdominis muscles are joined together by a thin, strong fibrous cord, the dawn linein the abdominal diastasis this cord thins and weakens, and the rectus muscles separate, moving, especially in their central area, towards the sides of the abdominal wall.
La abdominal diastasis, or diastasis of the rectus is often observed after pregnancyespecially (but not only) in the slim, sporty young women and with very toned abdominal wall; is not a true hernia, but is correctly defined as a dawn line failurewhich causes a weakening of the abdominal wall that tends to worsen over time and lead to symptoms such as back pain and theurinary incontinence (as well as definitely becoming unsightly). Also in theman, the diastasis recti can be present and cause disturbances that profoundly interfere with daily activities. The abdominal diastasis in men appears more frequently in abdomens subjected to considerable muscular stimulation (e.g. in sportsmen) or in overweight or obese patients, and can cause lumbago e respiratory and digestive difficulties.
Even today, General Surgeons underestimate the diastasis rectiand relegate it to the realm of aesthetic flaws; this view, however, is simplistic and takes little account of theimportance of abdominal muscle vectors in the execution of, for example, the breathing movementsin maintaining a correct standing position and in ensuring a correct function of the pelvic floor muscles.
For this, the abdominal diastasis must be considered as a real disease of the abdominal walldeserving due consideration and a correct corrective surgical approach.
Diastasis of the rectum: laparoscopic surgery (or rather, in endoscopy)
Even today, in our country, the vast majority of surgeons operating the diastasis of the rectus muscles do so through large incisions in the abdominal wall (the horizontal incision from
side by side abdominoplasty performed by Plastic Surgeons; the vertical incision from the sternum to the pubis by General Surgeons; and not infrequently, both incisions together), which are very painful, slow healing and not infrequently cosmetically hideous results. L'abdominoplasty in particular keeps its indications in the patients with an adipose apron seeking, in addition to the correction of functional problemsalso a cosmetic improvement of one's abdominal wall: but in cases where there are no pendulous abdomens or excess skin, abdominoplasty today è
an unnecessarily risky intervention and really too invasive to be justified (as well as presenting a very high risk of diastasis recurrence and complications, as international medical literature tells us) as a treatment of abdominal diastasis.
Today, however, there are minimally invasive techniques: diastasis of the rectus abdominis can be treated with laparoscopic, or rather endoscopic, surgery, thanks to which, with three small holes immediately above the pubis, it is possible to reconstruct the defect between the rectus muscles, finally placing a very light mesh to reinforce the wall, exactly as is done in surgery
Abdominal diastasis in men
La REPA is particularly effective for the treatment of abdominal diastasis in menmale patients greatly appreciate its minimally invasive, 'gentler' postoperative course and faster resumption of their usual activities.
We were the first in Europe, and we are the only ones in Italy, to perform the REPAthe minimally invasive endoscopic procedure for the correction of diastasis of the rectus; and we are proud to say that we now have the world's largest published case history for this type of surgery.
What is the difference between thelaparoscopic surgery for abdominal diastasis and intervention in endoscopy? The tools used are the same, but whereas with thelaparoscopic (or robotic) surgery you enter the abdominal cavity, with theendoscopy surgery you stay outside of it, on the surface of the rectus muscles: the risk of postoperative complicationssuch as the injury of abdominal viscera, is as follows very small. In addition, with thelaparoscopic or robotic operation for rectus diastasis cannot, for anatomical reasons, fully plicate (i.e. stitch) the fascia of the rectus abdominis muscles, whereas with theendoscopy surgery yes.
L'endoscopic surgery for the diastasis recti - the REPA - is really minimally invasivethe patient's hospitalisation is only one night and the postoperative course is particularly mild and without major patient discomfort. But our focus on the treatment of diastasis recti does not end with surgery: we were the first in Italy to introduce a multidisciplinary therapeutic programmewhich provides a course of physiotherapeutic rehabilitation of the abdominal wall muscles, postural homeostasis and pelvic floor function through an extraordinary protocol of hypopressive gymnastics.