# Long-term patient-reported outcomes after plication of rectus diastasis and simultaneous herniorrhaphy with HELP abdominoplasty

## TL;DR

This study shows that a mesh-free surgical technique called HELP abdominoplasty effectively treats rectus diastasis and small hernias in post-pregnancy patients with low complication rates over five years.

## Contribution

The study demonstrates that mesh is not always necessary for treating rectus diastasis and small hernias using a comprehensive plication technique.

## Key findings

- No patients experienced recurrence of diastasis or hernias after a mean follow-up of 5.2 years.
- The overall complication rate was 11.8%, indicating the procedure is relatively safe.
- The technique is effective for normal-weight women with moderate to severe post-pregnancy rectus diastasis and small hernias.

## Abstract

Midline hernias are common, and when associated with abdominal rectus diastasis, hernia guidelines recommend correction using mesh techniques. We present a retrospective series of patients with primary midline hernias and post-pregnancy moderate or severe abdominal rectus diastasis, who were operated using a comprehensive surgical approach without mesh.

We previously described the HELP (Hydrodissection-Assisted Extended Lateral Plication) abdominoplasty technique for rectus diastasis repair, with or without a midline hernia. In this study, patient records from 2013 to 2018 were reviewed, and patients with a midline hernia who underwent the HELP abdominoplasty were recruited for a retrospective analysis.

Seventeen patients were successfully contacted. The mean diameter of the umbilical hernia defect was 13.6 mm (5–30 mm), and 7.7mm (5–20 mm) in epigastric hernias. The mean follow-up period was 5.2 years. None of the patients reported a recurrence of diastasis or of hernias. The overall complication rate was 11.8%.

HELP abdominoplasty appears to be a reliable surgical treatment with a low complication rate for normal-weight women with post-pregnancy moderate to severe rectus diastasis and concomitant small primary hernias. In these cases, the entire damaged fascia should be repaired, and mesh correction is not always necessary.