Ventral hernia repair associated to diastasis of rectus abdominis muscles by endoscopic approach. Preliminary results

Abstract

Introduction: Diastasis of the rectus abdominis muscle (DRAM) is often associated with the presence of hernias in the abdominal wall, being a aesthetic and symptomatic problem. The repair of both defects through the pre-aponeurotic linea alba reconstruction (REPA) has got very good results. Describe the initial experience of diagnosed patients with DRAM and linea alba hernia, operated with REPA technique. Materials and methods: Descriptive, observational and retrospective study of 10 patients with DMRA and linea alba hernia, operated with REPA technique. Age, sex, Body Mass Index (BMI), hernia size and number of defects, mean of diastasis extension, operating time, long of hospitalization, postoperative complications (seroma, hematoma, post-op pain, recurrences of hernia or DRAM) were used as control variables. Results: One hundred eighty-day follow up results are available for all patients. The patients comprised 3 men and 7 women, with a mean age of 54 years and mean BMI of 32,6. Five patients had other diseases. The mean of defects in the abdominal wall was 1,3, with a mean hernia defect size of 1,67 cm. The mean of diastasis extension was 3,74 cm. The mean operating time was 68,5 min. Patients were hospitalized for an average of 2 days. Seven of 10 patients (70 %) experienced no postoperative complications. Two cases of hematoma and one case of minimum seroma. The mean of 48 hours post-op pain (Analog scale) was 4. All patients returned to their activities in 25 days. On 30 day follow-up, 0 of 10 patients was reported pain greater to 3. Six months follow-up, showed no recurrences. Conclusion: REPA technique allows the repair of DMRA and linea alba hernias without the need to enter in the abdominal cavity, without recurrence in the short time. The procedure has few complications and minimum post-op pain.