Correction of recurrent diastasis in outcomes of abdominoplasty (tummytuck)
A significant percentage of patients undergoing traditional abdominoplasty (tummytuck) for rectus abdominis diastasis may experience diastasis recurrence, that is, recurrence of the pathology.
In these cases we are faced with patients who , in addition to having the typical abdominoplasty (tummytuck) scars , have diastasis again, sometimes even more severe than at the beginning.
The reasons for failure in traditional reconstructions as well as endoscopic reconstructions, beyond any general issues such as excessive body weight gain or subsequent pregnancies, originate in the probable structural fragility of the anterior plications of the rectus muscles.
The mesh, placed anterior to the abdominal wall, also probably behaves differently under stress than pre-peritoneal or posterior mesh.
Such sutures probably, being anteriorly unbalanced do not distribute the forces as evenly as the central sutures that are performed in robotics.
In most cases, there is no involvement of deep states or visceral adhesion phenomena that we often find in laparoscopy.
In resolving these cases, it is logical to change structural approach in favor of a more anatomical realignment of the rectus muscles.
In the cases we treated, we achieved this with the robotic surgery approach R-Tapp that takes advantage of the pre-peritoneal working plane.
Thus, it was possible to reconstruct the integrity of the abdominal wall by taking advantage of an intact floor compared with previous surgery.
Often then upon completion of reconstruction if necessary, cosmetic and ameliorative surgery is performed on the previous scars.