Long-term patient-reported outcomes after plication of rectus diastasis and simultaneous herniorrhaphy with HELP...

Midline hernias are common, and when associated with abdominal rectus diastasis, hernia guidelines recommend correction using mesh techniques. We present a retrospective series of patients with primary midline hernias and post-pregnancy moderate or severe abdominal rectus diastasis, who were operated using a comprehensive surgical approach without mesh.

We previously described the HELP (Hydrodissection-Assisted Extended Lateral Plication) abdominoplasty technique for rectus diastasis repair, with or without a midline hernia. In this study, patient records from 2013 to 2018 were reviewed, and patients with a midline hernia who underwent the HELP abdominoplasty were recruited for a retrospective analysis.

Seventeen patients were successfully contacted. The mean diameter of the umbilical hernia defect was 13.6 mm (5-30 mm), and 7.7mm (5-20 mm) in epigastric hernias. The mean follow-up period was 5.2 years. None of the patients reported a recurrence of diastasis or of hernias. The overall complication rate was 11.8%.

HELP abdominoplasty appears to be a reliable surgical treatment with a low complication rate for normal-weight women with post-pregnancy moderate to severe rectus diastasis and concomitant small primary hernias. In these cases, the entire damaged fascia should be repaired, and mesh correction is not always necessary.