Simple plication alleviates physical symptoms in patients with post-gestational rectus diastasis

PurposeTo evaluate our surgery for post-gestational rectus abdominis muscle diastasis using slowly absorbable monofilament suture and eight weeks of abdominal binder in terms of recurrence rate, complications, and effect on patients' physical and cosmetic complaints.MethodIn a retrospective cohort study, all 44 patients operated between 2014 and 2020 were invited to a follow-up using ultrasound, clinical examination, and questionnaires regarding symptoms before and after surgery.Results89% of invited patients participated, with a median follow-up of 36 months. There was one recurrence caused by severe postoperative nausea and vomiting, which was the most common complication. Most procedures were safe, but two patients experienced Clavien-Dindo grade 3 complications. Patients reported feeling limited or taking precautions after surgery for a median of 8.5 months. Of all included patients, four responded that the operation did not alleviate their primary complaint. The remaining 35 patients (90%) experienced complete or partial alleviation of their primary complaints and would undergo the procedure again if needed.ConclusionPost-gestational diastasis recti can be associated with a large number of physical symptoms and functional complaints and can safely be operated using a single running plication of the anterior rectus fascia with a slowly absorbable suture, with fair cosmetic results, excellent effect on symptoms, few complications and high levels of patient satisfaction. Future research must determine which symptoms and findings should indicate surgery.