What is diastasis recti?
Diastasis develops when the linea alba widens and thins, causing the rectus abdominis muscles to move apart.
Diastasis may present as:
- a bulge along the midline of the abdomen
- a change in the shape of the abdomen
- a feeling that the abdominal wall is unstable
- pain or discomfort
- weaker abdominal muscles
- difficulty with physical exertion
Diastasis is often combined with hernias of the front abdominal wall, particularly umbilical and epigastric hernias.
Our approach
Before a treatment method is chosen, the entire front abdominal wall is assessed.
The following are taken into account:
- the width and length of the diastasis
- the condition of the linea alba
- the location of the diastasis
- the presence of an umbilical or ventral hernia
- the condition of the abdominal muscles
- previous operations
- the presence of scars
- symptoms and functional problems
- the patient's general condition
For detailed planning in complex cases, *CT of the abdominal wall* or ultrasound may be used.
The goal of treatment is not only to reduce the visible bulge but to restore the anatomy and function of the front abdominal wall.
When is surgery needed?
Surgical correction may be recommended for:
- marked diastasis
- progressive separation of the rectus muscles
- pain or discomfort
- impaired abdominal wall function
- significant abdominal deformity
- symptoms that cannot be controlled effectively with conservative methods
- diastasis combined with an umbilical or ventral hernia
Indications for surgery
Surgery is considered for patients with symptomatic or significant diastasis, especially if it is accompanied by:
- an umbilical hernia
- an epigastric hernia
- a ventral hernia
- a postoperative defect
- marked instability of the front abdominal wall
The strategy is determined individually after assessing the anatomy and symptoms.
How is the operation performed?
The operation is performed under anesthesia.
The technique depends on the width and length of the diastasis, the presence of hernias, and the condition of the tissues.
During the operation, the following may be performed:
- mobilization of the musculoaponeurotic structures
- restoration of the linea alba
- bringing the rectus abdominis muscles together
- suturing of the diastasis
- closure of an associated hernia defect
- reinforcement of the reconstructed area with a mesh implant
- comprehensive reconstruction of the front abdominal wall
When diastasis is combined with an umbilical or ventral hernia, both conditions can be treated during a single operation.
Diastasis correction techniques
Depending on the clinical situation, different techniques may be used:
- suturing of the linea alba
- midline reconstruction
- retromuscular reconstruction
- diastasis correction with a mesh implant
- component separation techniques
- *TAR (Transversus Abdominis Release)* for complex defects
- combined reconstructive techniques
The choice of operation depends on the anatomy, the width of the diastasis, the presence of a hernia, and the condition of the tissues.
Diastasis and hernia
Diastasis and a hernia are not the same thing.
In diastasis, the rectus muscles separate because the linea alba widens, but there may be no hernia opening.
In a hernia, there is a defect in the abdominal wall through which intra-abdominal contents can bulge.
At the same time, these conditions often occur together. In such cases, comprehensive restoration of the entire front abdominal wall during one operation may be the best option.
Minimally invasive correction
In suitable cases, diastasis repair can be performed using laparoscopic or robotic technology.
The minimally invasive approach may make it possible to:
- reduce surgical trauma
- reduce postoperative pain
- lower the risk of wound complications
- mobilize the patient faster
- shorten the recovery period
Whether minimally invasive surgery is possible is determined individually.
Advantages of surgical correction
- Restoration of the anatomy of the linea alba
- The rectus abdominis muscles are brought back together
- Restoration of front abdominal wall function
- Repair of associated hernias
- Improved trunk stability
- Less abnormal abdominal bulging
- Comprehensive abdominal wall reconstruction is possible
Recovery after surgery
After surgery, early mobilization and a gradual increase in physical exertion are recommended.
Postoperative care includes:
- pain control
- early walking
- a gradual return to eating
- wound care
- a gradual return to physical activity
- monitoring of how the reconstructed abdominal wall heals
After complex reconstruction, the recovery period may be longer.
Patient care follows the principles of *ERAS (Enhanced Recovery After Surgery)*.
Our advantages
- Comprehensive assessment of the front abdominal wall
- Surgical correction of symptomatic and marked diastasis
- Associated hernias treated in the same operation
- Use of modern reconstructive techniques
- Minimally invasive correction in suitable cases
- Use of modern mesh implants when indicated
- Individual planning of the operation
- Restoring not only the shape but also the function of the abdominal wall
- Modern postoperative recovery protocols (ERAS)
Frequently Asked Questions
No. If diastasis does not cause significant symptoms or functional problems, surgical treatment may not be needed. The strategy is determined individually.
No. Diastasis is a separation of the rectus muscles due to widening of the linea alba, whereas a hernia involves a defect in the abdominal wall. However, these conditions can exist at the same time.
Yes. When diastasis is combined with an umbilical or other ventral hernia, they can be corrected during a single operation.
Not always. For small defects, suturing the tissues may be enough. With significant diastasis, an associated hernia, or weak tissues, additional mesh reinforcement may be recommended.
In suitable cases, yes. Minimally invasive or robotic reconstruction may be one of the treatment options, depending on the anatomy and associated defects.
For mild to moderate diastasis, exercises can improve muscle function and control of the abdominal wall. With significant symptomatic diastasis or an associated hernia, exercises do not always eliminate the anatomical defect, so surgical reconstruction may be considered.
A return to physical exertion is gradual, after a check-up by the surgeon. The timeframe depends on the extent of the reconstruction and whether there was an associated hernia.