The Long-Term Durability of Plication of the Anterior Rectus Sheath Assessed by Ultrasonography

ArticleinPlastic & Reconstructive Surgery 107(6):1578-84 · June 2001with24 Reads
DOI: 10.1097/00006534-200105000-00046 · Source: PubMed
The purpose of this study was to assess the long-term durability of a standard vertical plication of the anterior rectus sheath. For this purpose, 70 women who had undergone this procedure as part of an abdominoplasty were sent a questionnaire, their records were studied, and they were invited back to the clinic for an examination using ultrasound. A total of 63 patients returned the questionnaire, and 40 were willing to attend a follow-up consultation and ultrasound investigation. The presence of rectus diastasis was assessed by ultrasound (a real time scanner with a 7.5-MHz linear probe). The study showed that after a follow-up of 32 to 109 months (mean, 64 months), standard plication of the abdominal wall with absorbable material led to residual or recurrent diastasis in 40 percent of the patients. It also confirmed that vertical plication only is not enough to improve the waistline and may eventually lead to epigastric bulging.
    • "Controversy also exists over the analysis of the duration of the plication of the diastasis recti. Different studies value the recurrence of the diastasis after the plication of both muscular aponeurosis, but the majority of these have a small sample size, are retrospective and with a short follow-up period [11, 12]. Tadiparthi et al. [13] prospectively studied 28 patients subjected to abdominoplasty with diastasis recti, carrying out a plication of the aponeurosis using continuous suture of Nylon 0. With an average follow-up of 28 months, no recurrences of diastasis were found using clinical and ultrasound exploration. "
    [Show abstract] [Hide abstract] ABSTRACT: Purpose To evaluate prospectively the feasibility and the duration of the plication of both aponeurosis through a totally endoscopic approach to the diastasis recti associated with midline hernias, correcting both pathologies simultaneously and objectively looking at their advantages and complications. Methods The prospective cohort study included patients suffering from midline hernias equal to or bigger than 2 cm size and associated diastasis recti, from April 2011 to October 2012. Full endoscopic subcutaneous approach is used to perform the surgery. An ultrasound scan was carried out to identify inter-rectus distances and recurrences in xiphoid, 3 cm supraumbilical and 2 cm subumbilical locations. Results A total of 21 patients were included in the study, with a mean follow-up of 20 months. The main complication was seroma. A significant reduction in the average distance between the rectus muscles was shown before surgery and at 1 month postoperative measures in all three locations (p
    Full-text · Article · Aug 2014
    • "L'intervention est courte et bien codifiée ; de ce fait, les deux équipes peuvent travailler ensemble harmonieusement et efficacement sans perte de temps. Bien entendu, le recul est encore insuffisant [7] pour en tirer des conclusions définitives et nous prévoyons de faire un nouveau bilan dans trois ans avec scanner de contrôle systématique pour toutes les patientes. "
    [Show abstract] [Hide abstract] ABSTRACT: In 10 cases of abdominoplasty where an important rectus diastasis had to be corrected, we completed the plication of the rectus sheath included in a classical abdominoplasty with the laparoscopic positioning of an intraperitoneal prosthesis. Purpose To assess the middle-term results of this technique and present its advantages and drawbacks. Patients and method Fifteen patients have been operated from 2007 to 2011 by two surgeon teams. Ten of them have accepted to be included in our survey. Results All the patients said they were satisfied with their surgery. Four of them reported mild pain during the first postoperative weeks, and two of them mentioned very moderate pain at the time of the survey. The surgeons were not satisfied with the results obtained in two cases. Only one of these two patients accepted revision abdominoplasty with a good result. Conclusion Laparoscopic positioning of an intraperitoneal prosthesis, coupled with a classical plication of the rectus sheath, gives excellent results in difficult cases of rectus diastasis.
    Full-text · Article · Aug 2012
    • "The durability of diastasis repair has been well-documented.[15] The effect of intra-abdominal fat content resulting in the protruded appearance after the surgery has been highlighted by only few authors.[14] "
    [Show abstract] [Hide abstract] ABSTRACT: Extensive liposuction along with limited dissection of abdominal flaps is slowly emerging as a well proven advantageous method over standard abdominoplasty. A retrospective study analyzed 146 patients managed for the abdominal contour deformities from March 2004 to February 2010. A simple method to project the post operative outcome by rotation of a supine lateral photograph to upright posture in 46 patients prospectively has succeeded in projecting a predictable result. All patients were encouraged to practice chest physiotherapy in 'tummy tuck' position during the preoperative counseling. Aggressive liposuction of entire upper abdomen, a limited dissection in the midline, plication of diastasis of rectus whenever indicated, panniculectomy and neoumblicoplasty were done in all patients. The patients had a mean age of 43, youngest being 29 and oldest 72 years. Majority were of normal weight (94%). Twelve were morbidly obese; 57 patients had undergone previous abdominal surgeries; 49 patients had associated hernias. Lipoabdominoplasty yielded a satisfactory result in 110 (94%) patients. The postoperative patient had a definitely less heavy harmonious abdomen with improved waistline. The complications were more with higher BMI, fat thickness of more than 7 cm and prolonged operating time when other procedures were combined. Extensive liposuction combined with limited dissection method applied to all abdominoplasty patients yielded consistently safe, reliable and predictable aesthetic results with less complications and faster recovery. The simple photographic manipulation has helped project the postoperative outcome reliably. The preoperative chest physiotherapy in tummytuck position helped prevent chest complications.
    Article · Mar 2012
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