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Hernia

, Volume 23, Issue 5, pp 1017–1018 | Cite as

Diastasis recti and primary midline ventral hernia: the plastic surgery approach

  • D. P. Baumann
  • C. E. ButlerEmail author
Letter to the Editor
  • 93 Downloads
Part of the following topical collections:
  1. Forum on primary midline uncomplicated ventral hernia

When a true hernia is encountered in the setting of rectus diastasis (RD), the hernia defect determines the appropriate treatment. Several decisions need to be made, such as whether to perform a minimally invasive or open procedure, what type of mesh to use, and the plane of mesh placement. However, it is the presence of the concomitant RD that determines the extent of mesh reinforcement beyond the hernia defect itself. This is critically important because hernia recurrence risk at the junction of the hernia defect and area of RD is very high if the RD is not adequately addressed at the time of hernia repair. The mesh must be inset, both superior to and inferior to the hernia, to stable soft tissue such as normal (non-attenuated) rectus complexes, subxiphoid tissue, or the terminal insertion of the rectus musculofascia in the suprapubic region. The plane of mesh placement is at the discretion of the surgeon based on individualized patient factors, case complexity, and their surgical...

Notes

Compliance with ethical standards

Conflict of interest

The authors do not have any conflicts of interest to disclose.

Ethical approval

For this type of study ethical approval was not necessary.

Human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

References

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    Butler CE, Baumann DP, Janis JE, Rosen MJ (2013) Abdominal wall reconstruction. Curr Probl Surg 50(12):557–586CrossRefGoogle Scholar
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    Ghali S, Turza KC, Baumann DP, Butler CE (2012) Minimally invasive component separation results in fewer wound-healing complications than open component separation for large ventral hernia repairs. J Am Coll Surg 214(6):981–989CrossRefGoogle Scholar
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    Giordano S, Garvey PB, Baumann DP et al (2017) Concomitant panniculectomy affects wound morbidity but not hernia recurrence rates in abdominal wall reconstruction: a propensity score analysis. Plast Reconstr Surg 140:1263–1273CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Plastic SurgeryThe University of Texas MD Anderson Cancer CenterHoustonUSA

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