One of the techniques currently available to treat diastasis recti – a condition which causes the progressive and irreversible separation of the two rectus abdominis muscles and the weakening of the linea alba – is robotic surgery, which allows surgeons to treat the condition successfully from both an aesthetic and functional standpoint.

This particular technique is considered the latest frontier of minimally-invasive surgery, and allows the surgeon to operate in the narrow preperitoneal space, using a cutting-edge instrument known as the da Vinci operating robot, allowing reconstructive surgery which was previously impossible using conventional manual, laparoscopic and endoscopic instruments.
Globally, Italy has distinguished itself as regards the treatment of diastasis recti, thanks to Dr. Antonio Darecchio, director of the abdominal wall robotic surgery team at the Columbus Clinic in Milan. Dr. Darecchio has developed a technique for the reconstruction of the abdominal wall, setting a new standard in the treatment of this condition.

What is diastasis recti?
Diastasis recti is a condition which mainly affects women, and tends to occur most frequently after pregnancy, causing the progressive separation of the rectus abdominis muscles due to the weakening and thinning of the tendon known as the linea alba. It can also be caused by sudden changes in visceral fat volume, or by excessive physical exercise in the case of professional athletes.
As well as causing abdominal bloating (sufferers often report feeling as if they are still pregnant), diastasis recti can also lead to other serious problems, such as backache due to poor posture, or increased urinary frequency correlated to an incomplete emptying of the bladder. This condition should not be ignored, as it is progressive and irreversible: it should also be noted that diastasis recti affects the abdominal tendons which surround the rectus abdominis muscles and hold them together at the linea alba, rather than the muscles themselves.
This means that physical exercise is not beneficial, even if it is targeted and specific. Once damaged, the tendons will not heal on their own, and surgery is the only option. Another important aspect of diastasis recti which should not be underestimated is that the condition causes the progressive weakening of the linea alba, which can cause the formation of epigastric or umbilical hernias, or aggravate existing ones.

What are the symptoms of diastasis recti?
Often the symptoms of diastasis recti are not related to the abdomen, which can make them difficult to recognise. There are several self-diagnosis tests that patients can do, although these are not always particularly simple or straightforward. Patients of normal weight can test for the condition by lying on their back and lifting their head or chest, as if doing an abdominal crunch.
Diastasis recti will cause the appearance of an elongated and oval deformation between the lower part of the sternum and the navel. An abnormal weakness of the tissues can be felt by putting a hand over the area.
In some cases, it is even possible to feel the pulsing of the abdominal aorta with the fingers, or observe odd intestinal movements. To accurately diagnose the condition and its severity, patients should consult a specialist. The actual distance between the two rectus muscles can be established via an ultrasound of the abdominal wall using specific criteria.

How is diastasis recti treated?
To treat diastasis recti, many people still opt for an abdominoplasty, an open and highly invasive procedure, which leaves visible scars and brings the rectus muscles together in a way that is somewhat fragile, without respecting their correct anatomical position. The mesh positioned just under the skin to reinforce the repair can potentially cause visible and extremely bothersome imperfections: the mesh tends to be perceptible to the touch in very slender patients, and may even be visible under the skin. Since the procedure involves large incisions and the insertion of surgical drains to remove fluids from the surgical site, the postoperative course is not only long but also painful. Other patients instead opt for endoscopic or laparoscopic techniques to treat the condition, and while these prevent visible scarring, they also share a number of issues with standard abdominoplasty.
Robotic surgery is the most advanced treatment for diastasis recti, and involves use of the da Vinci operating robot, a revolutionary instrument which in expert hands results in stable and long-lasting repairs. The procedure permits the perfect reconstruction of the abdominal wall, restoring the rectus muscles to their original anatomical position, exactly as they were prior to the onset of the condition. Use of a robot to perform the surgery should not be a cause for alarm, since the robot does not work alone, but reproduces the surgeon’s movements on a much smaller scale.

Who can perform robotic surgery?
Robotic surgery requires specific experience and specific training that most surgeons do not have, especially those of the “old guard”. For this reason, patients who wish to undergo this minimally invasive procedure with its rapid and relatively painless postoperative course should not be afraid to ask their surgeon how many patients they have treated using robotic surgery, and should ask to see the results achieved in other diastasis recti patients.

Robotic repair of the abdominal wall for the treatment of diastasis, in expert hands, guarantees excellent results, both aesthetic and functional, as can be seen on the Instagram profile of Dr. Darecchio (https://www.instagram.com/darecchio_chirurgo/), who takes pride in having treated the largest number of cases and offers the widest experience in the field.
With no surgical drains to manage, no unnatural or visible mesh, and no unsightly scars, patients can return to their normal daily activities – with a few changes – immediately after surgery. It is also important to remember that the symptoms caused by the condition disappear following the procedure. Patients are also able to regain the physique they had prior to diastasis onset, while the skin in the treated area is tightened and more toned, even on the surface.