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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?

diastasis, diastasis of the rectus abdominis muscles,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

rectus diastasis laparoscopic surgery, abdominal diastasis man, abdominoplasty
This patient has a correct indication for abdominoplasty, due to the presence of a pendulous abdomen and excess skin

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

male abdominal diastasis, rectus diastasis
This patient, however, has no indication for abdominoplasty: no excess skin, no pendulous abdomen.

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

diastasis of the rectus laparoscopic surgery
The invasiveness of abdominoplasty and its most feared complication: necrosis of the abdominal skin

of hernias.

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.

Learn more about rectus diastasis and laparoscopic surgery in both men and women, call us at  0110438161 , write to us using the form below or book a visit.

48 thoughts on “Diastasi addominale: intervento in laparoscopia”

  1. I have had four pregnancies and unfortunately it is getting worse I would like to know more about it

  2. Good morning two years ago I had a twin pregnancy I feel the separation of the rectus abdominis in case of surgery is possible with health service? Thank you

      1. Hello doctor, I wanted to know if the distance between the rectums has to be large in order to be able to have this operation. I had an ultrasound which showed diastasis of just over 1 cm but my belly is very swollen and, like all of us who have this problem, I look perpetually pregnant. Your technique would be the ideal solution for me but I don't know if it can be done in my case. I would be infinitely grateful if you could enlighten me! Thank you

        1. Good evening. Ultrasound underestimates diastasis not infrequently! It depends on how it is performed and the experience of the performer. That is why I always make the surgical indication only after examining the patient, and NEVER on the basis of the ultrasound alone. Why don't you come and see me in my office? Kind regards.

          1. Thank you doctor, I certainly intend to come to you for a thorough examination and above all to better understand my situation. The fact is that I'm from Bari and your practice is a bit far away. I need to understand how to organise myself.
            I really don't understand how an apparently minimal diastasis can lead to such unsightly swelling and a perpetual balloon.
            Thanks again, see you soon!

        2. Good morning. From a classification point of view, a separation of the recti < 2.5 cm cannot be classified as diastasis. Therefore, below these measurements, there is no surgical indication either.

      2. I discover that I have the characteristic protrusion attributable to diastasis (a kind of 'fin' along the 'alba' line), but on manually inspecting the gap it does not seem to reach 2 or 3 cm. The protrusion, however, is hard, consistent... I also wonder whether, given the presence of this protrusion, it is advisable to do the classic abdominal exercises. I am a 62-year-old man. Thank you. Best regards.

      3. Hello doctor, I've had two pregnancies, the last one 5 and a half years ago, through an abdominal CT scan I was found to have a diastasis of the rectus muscles of almost 4 cm and an herniary prominence, I'm very scared of the abdominaplasty scar that goes from one helical spine to the other and in general the post-surgery, I'm looking for, I have a globular abdomen, I'm trying to understand if there are other techniques, I'd like to have the belly I had before without the discomfort that I have. Thank you in advance

          1. Hello Doctor, yes I definitely have to come for a visit but I have to organise myself, I live in Sicily .
            Thank you very much for your reply

      4. Good evening I have had four pregnancies and unfortunately I have this problem in my second pregnancy..but I have heard that the operation costs a lot, can you tell me how much this type of operation costs?

        1. Dear Madam, if the conditions are met, the operation can be performed within the National Health Service. To find out, however, you must visit us: we are the only ones in Italy who perform this procedure!

      5. Hello Doctor,
        I am from Padua and I wanted to know approximately how long the wait would be for the operation.
        I will try to contact anyway to schedule a visit.
        You are the only ones in Italy who perform this operation, aren't you? Can you possibly recommend any of your colleagues here in Veneto?

      6. Dear doctor, is it also possible to have the operation privately or only on the National Health Service? Because the times with the National Health Service are very long in general...
        Thank you

      7. Maria Liliana Bizzotto

        Hello I have a diastasis 2cm after a twin pregnancy, and it has caused me several problems, I would like a visit with you to find out more about my situation,

      8. Gilda senhora da Silvia

        Hello Doctor . I am from Cassano magnago and I am very interested . I have had 3 pregnancies and I wanted to know more about how I can make an appointment . Unfortunately I am a cleaner in Malpensa and I work shifts, so I would like to know your availability. Thank you.

        1. Good evening. Booking a visit is easy: call 0110438161, our answering machine, and leave your name and phone number; I will call you back as soon as possible. Thank you and have a good evening.

      9. Good evening, I would like to ask you a question. I have an appointment for plastic surgery and have already had an abdominal echo.

      10. Maria Antoinette Borrea

        This is very interesting. I have been looking for the least invasive solution to this problem for years....

      11. Hello, I would be interested to know if, in the presence of excess skin (not much) and a protruding navel, this technique is also functional from an aesthetic point of view. Would the belly button be indented? Thank you.

        1. Good morning. REPA is a functional technique, not an aesthetic one: it repairs the problems caused by diastasis, but since no incisions are made it is not possible to remove excess skin. It is also true that sometimes patients identify the 'bulge' of the abdomen with excess skin, which it is not. The belly button, with this operation, regains its natural shape.

      12. Hello, I am 47 years old and have three children. I have always been a sportswoman with a slim build, and I have a significant diastasis that conditions me but does not stop me wanting to do sport (I train up to 5 times a week), if it were not for the belly button that betrays its presence (it is in fact protruding and with folds of skin) and the possibility that some intestinal loops could herniate. Don't you have any other clinics to visit besides Chivasso?.... I am very interested in this surgery technique. Thank you and I await your reply. Stefania Pilla from L'Aquila.

      13. Dear doctor I have a question about your technique which is very good for normal weight people, you say that you apply a mesh which stabilises the result thanks to the fibrous tissue that is created but can't you insert a resorbable mesh which acts as a scaffold when it will be colonised by the cells of our body and will give way to new facial tissue which will stabilise the result of the operation ....non and always better than a foreign body ? Thank you for your answer

        1. Good evening. The resorbable prostheses currently available are not able to induce an adequate inflammatory response and thus an adequate fibrotic reaction. More efficient prostheses in this respect will probably be available in the future. On the other hand, the prosthesis I use is so light (19 mg/sq.m.) that, once shaped for repair, its weight is about half a gram: less than that of the sutures normally used by plastic surgeons, for example, in diastasis repair via abdominoplasty. A truly negligible amount of material, in short.

      14. Hello, I have had three pregnancies in the space of six years, now I have diastasis but, as I have a slim physique, I wanted to find out whether by performing the operation with this technique I could also solve the problem aesthetically? Thank you if you can answer me.

      15. antonio fiorito fanti

        good morning, Excuse me, but isn't the purpose of resorbable mesh to avoid the creation of fibrotic tissue and only induce the creation of fascial tissue to stabilise the operation?...maybe I didn't understand the answer ...

        1. I probably misunderstood myself. In the repair, 'fascial' tissue is not formed (otherwise it would be called 'regeneration') but fibrotic tissue. Resorbable implants are not able to promote this formation efficiently and effectively, and moreover they disappear after some time, leaving a weak wall. The opposite happens with non-absorbable implants. Maybe this will change in the future...

      16. Good morning doctor. Do you also operate under an agreement with the ssn? Or only privately? I know that above 5 cm of diastasis some operations are covered by the National Health Service but many others are not. I also wanted to know what are the chances of recurrence with this type of surgery compared to laparoscopic surgery. Thank you.

        1. Good morning. I operate both on the SSN, with the limits imposed by it (size of the diastasis, simultaneous presence of hernias, etc.) and by the current pandemic (currently we do not perform non-urgent operations, it will probably be many months before we can return to diastasis surgery) and privately. Recurrences are very few, around 1-2%, compared to abdominoplasty (where they are reported, in some case histories, up to 40%); with respect to laparoscopic surgery it is difficult to say, there are no published data to that effect: laparoscopy, as well as robotic surgery, are not sufficiently standardised and validated techniques for diastasis surgery.

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