Rectus diastasis

Pictures above:

• a, rectus diastasis (1) in the area of the linea alba between the straight abdominal muscles (2)
• b, normal findings

What is rectus diastasis?

Rectus diastasis is aweakness of the abdominal wall between the two straight abdominal muscles. The fiber structure located here, called the linea alba, is overstretched and causes the straight abdominal muscles to shift from the midline to the side.

A common reason for rectus diastasis is pregnancy, especially in the case of multiple pregnancies. Despite normalization of weight after pregnancy, the abdomen appears rounded. On palpation, rectus diastasis is noticeable due to a lack of resistance when tensing the abdominal muscles. In pronounced cases, a bulge can be seen in the midline.

Excess weight can also cause the abdominal wall to expand and create a rectus diastasis. Midline weakness after abdominal surgery with a midline incision is not actually a true rectus diastasis, but rather an incisional hernia, as there is a weakness of the scar and not a weakness of the actual linea alba.

How is rectus diastasis surgery performed?

Conservative measures cannot achieve consolidation. Nevertheless, there is usually no reason for surgery. In mild and moderate cases, rectus diastasis is only an aesthetic problem with no symptoms. As rectus diastasis after pregnancy is usually associated with excess skin, it can be corrected as part of a tummy tuck. Internal sutures are used to fix the abdominal muscles in the desired position.

In the case of very pronounced findings and incisional hernias after abdominal surgery, it is usually necessary to insert plastic mesh to stabilize the abdominal wall. However, this is referred to as an epigastric hernia or abdominal wall hernia rather than a rectus diastasis. With a mini tummy tuck, the rectus diastasis can only be insufficiently corrected, as only the area from the mons veneris to the navel is exposed.

During liposuction in the abdominal area, attention must be paid to abdominal wall weaknesses, such as rectus diastasis and umbilical hernia, in order to prevent injury to internal organs through the cannulas via the hernia gap.

How is aftercare carried out?

In principle, the aftercare is the same as for a tummy tuck.

The recommendations are highly dependent on the extent of the rectus diastasis. In general, however, physical rest and abstinence from sport for 6 weeks is recommended. Corsetry should be worn for the same length of time. In the first 1-2 weeks, a slightly bent posture reduces the tension on the abdominal wall, which benefits the stability of the suture. Attention should also be paid to stool regulation. Flatulence and constipation have a negative effect on the outcome of the operation.

Sources:

• Atlas of Human Anatomy – Sobotta – Urban and Fischer – 2 volumes – Munich, Jena 2000
• Hernias – Schumpelick – Thieme – 2000