REPA, minimally invasive endoscopic surgery for abdominal diastasis

Diastasis recti is a separation of the rectus abdominis muscles favored by progressive weakening of the midline. It is a pathology that appears in both sexes, however, it is more frequent in women after pregnancy and is frequently associated with midline hernias. This separation is not a disease per se, but it often behaves as such due to the appearance of side effects, such as back pain and abdominal distension, especially when a hernial defect coexists or occurs in the linea alba, the black line that normally appears during pregnancy and runs from the navel to the pubic bone. Dr. Martín Martín, specialist in General Surgery, tells us about minimally invasive endoscopic surgery for its treatment.

REPA is a minimally invasive surgical method using a preaponeurotic endoscopic access to treat this type of pathology. It was first described in the Revista Hispanoamericana de Hernia by Juarez Muas in 2017 (1). He described the procedure based on the approximation of the rectus muscles and the placement of a reinforcement preaponeurotic mesh. All this, without entering the abdominal cavity achieving good aesthetic as well as functional results.

Endoscopic surgery, therefore, achieves in the patient is to restore the linea alba and treat its associated defects through a minimally invasive approach without the need for extensive scarring.

The authors who described the technique recommend the REPA method to any patient who wishes to correct the aesthetic alteration of the abdominal wall when the diastasis is greater than 2.5 centimeters, associated or not with midline hernias such as, for example, an umbilical hernia, associated with pain or distension. Patients with indication for abdominoplasty, who reject this operation because of its aggressiveness and extensive scarring, are also candidates for surgery with the REPA method.

Read Now 👉  How to treat obesity with surgery?

In conclusion, diastasis is an anatomical and common variation of the linea alba that, progressively, can alter aesthetics, but sometimes, due to its dimensions or coexistence with hernial defects, produces symptoms that can be treated in a minimally invasive way with minimally invasive endoscopic surgery REPA.

(1)Juárez Muas DC, et al. reaponeurotic endoscopic repair Multicenter study (REPA) as treatment of the diastasis of the recti associated or not to hernias of the middle line. Revista Hispanoamericana de Hernia 2018.