{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T22:50:39Z","timestamp":1780872639601,"version":"3.54.1"},"reference-count":58,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Rectus diastasis is a common condition that can result in a protruding abdomen, causing cosmetic and functional disability. Although it is usually repaired during abdominoplasty or herniorrhaphy, there is a lack of consensus with regard to the repair indications and optimal surgical techniques. The goal of this study is to provide an updated review of the surgical techniques used for rectus diastasis repair and their comparative efficacy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed, Embase, and Cochrane databases were searched for articles that discussed the surgical management of rectus diastasis and reported on either outcomes, complications, or recurrence rates. Data detailing surgical techniques were extracted, and pooled analyses of complication and recurrence rates were performed, controlling for surgical approach, common variations in technique, and an associated herniorrhaphy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Thirty-seven studies describing 45 techniques were included. An open rectus diastasis repair was performed in 24 of the studies. After controlling for an associated herniorrhaphy, there was no statistically significant difference in surgical complication and recurrence rates between open and laparoscopic approaches (<jats:italic toggle=\"yes\">p<\/jats:italic> = 0.165 and <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.133, respectively). Although a double-layer suture closure was associated with a significantly lower rate of complications (<jats:italic toggle=\"yes\">p<\/jats:italic> = 0.002), no significant difference was found for suture type absorbability.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Surgical repair of rectus diastasis is safe and effective through both open and laparoscopic approaches. Although suture type absorbability does not affect complication or recurrence rates, a double-layer suture closure can decrease surgical complications. The pooled analysis of complication and recurrence rates can help improve informed consent and patient education.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/prs.0000000000007252","type":"journal-article","created":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T00:02:28Z","timestamp":1603411348000},"page":"1151-1164","source":"Crossref","is-referenced-by-count":46,"title":["A Comprehensive, Evidence-Based Literature Review of the Surgical Treatment of Rectus Diastasis"],"prefix":"10.1097","volume":"146","author":[{"given":"Hassan","family":"ElHawary","sequence":"first","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, McGill University Health Centre; the Faculty of Medicine, McGill University; and the Department of Plastic Surgery, The Ohio State University Wexner Medical Center."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenzy","family":"Abdelhamid","sequence":"additional","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, McGill University Health Centre; the Faculty of Medicine, McGill University; and the Department of Plastic Surgery, The Ohio State University Wexner Medical Center."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanyi","family":"Meng","sequence":"additional","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, McGill University Health Centre; the Faculty of Medicine, McGill University; and the Department of Plastic Surgery, The Ohio State University Wexner Medical Center."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey E.","family":"Janis","sequence":"additional","affiliation":[{"name":"From the Division of Plastic and Reconstructive Surgery, McGill University Health Centre; the Faculty of Medicine, McGill University; and the Department of Plastic Surgery, The Ohio State University Wexner Medical Center."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,10,23]]},"reference":[{"key":"R1-20230801","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1097\/PRS.0b013e3181882493","article-title":"Diastasis recti: Clinical anatomy.","volume":"122","author":"Brauman","year":"2008","journal-title":"Plast Reconstr Surg"},{"key":"R2-20230801","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1136\/bjsports-2016-096065","article-title":"Diastasis recti abdominis during pregnancy and 12 months after childbirth: Prevalence, risk factors and report of lumbopelvic pain.","volume":"50","author":"Sperstad","year":"2016","journal-title":"Br J Sports Med"},{"key":"R3-20230801","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1097\/00006534-199805000-00042","article-title":"Rectus muscle diastasis in males: Primary indication for endoscopically assisted abdominoplasty.","volume":"101","author":"Lockwood","year":"1998","journal-title":"Plast Reconstr Surg"},{"key":"R4-20230801","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/BF01627606","article-title":"The abdominal linea alba: An anatomo-radiologic and biomechanical study.","volume":"18","author":"Rath","year":"1996","journal-title":"Surg Radiol Anat"},{"key":"R5-20230801","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1002\/ca.20836","article-title":"The normal width of the linea alba in nulliparous women.","volume":"22","author":"Beer","year":"2009","journal-title":"Clin Anat"},{"key":"R6-20230801","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fsurg.2019.00001","article-title":"Classification of rectus diastasis: A proposal by the German Hernia Society (DHG) and the International Endohernia Society (IEHS).","volume":"6","author":"Reinpold","year":"2019","journal-title":"Front Surg"},{"key":"R7-20230801","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1097\/SAP.0000000000001694","article-title":"Surgical management of diastasis recti: A systematic review of insurance coverage in the United States.","volume":"83","author":"Rosen","year":"2019","journal-title":"Ann Plast Surg"},{"key":"R8-20230801","first-page":"62","article-title":"Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: A randomised controlled trial.","volume":"19","author":"Thabet","year":"2019","journal-title":"J Musculoskelet Neuronal Interact"},{"key":"R9-20230801","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1093\/ptj\/pzx117","article-title":"Relationship between interrectus distance and symptom severity in women with diastasis recti abdominis in the early postpartum period.","volume":"98","author":"Keshwani","year":"2018","journal-title":"Phys Ther"},{"key":"R10-20230801","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1007\/s00192-006-0143-5","article-title":"Prevalence of diastasis recti abdominis in a urogynecological patient population.","volume":"18","author":"Spitznagle","year":"2007","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"R11-20230801","doi-asserted-by":"crossref","first-page":"163","DOI":"10.3109\/2000656X.2013.859145","article-title":"Rectus abdominis diastasis.","volume":"48","author":"Akram","year":"2014","journal-title":"J Plast Surg Hand Surg"},{"key":"R12-20230801","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1080\/2000656X.2016.1222293","article-title":"Abdominal plasty with and without plication: Effects on trunk muscles, lung function, and self-rated physical function.","volume":"51","author":"Wilhelmsson","year":"2017","journal-title":"J Plast Surg Hand Surg"},{"key":"R13-20230801","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s10029-014-1300-2","article-title":"Totally endoscopic surgery on diastasis recti associated with midline hernias: The advantages of a minimally invasive approach. Prospective cohort study.","volume":"19","author":"Bellido Luque","year":"2015","journal-title":"Hernia"},{"key":"R14-20230801","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1097\/00000637-199401000-00017","article-title":"A simple technique for repair of rectus sheath defects.","volume":"32","author":"Asaadi","year":"1994","journal-title":"Ann Plast Surg"},{"key":"R15-20230801","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1097\/01.prs.0000302456.02109.04","article-title":"Use of a submuscular resorbable mesh for correction of severe postpregnancy musculoaponeurotic laxity: An 11-year retrospective study.","volume":"121","author":"Batchvarova","year":"2008","journal-title":"Plast Reconstr Surg"},{"key":"R16-20230801","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1097\/PRS.0000000000000840","article-title":"Simultaneous prosthetic mesh abdominal wall reconstruction with abdominoplasty for ventral hernia and severe rectus diastasis repairs.","volume":"135","author":"Cheesborough","year":"2015","journal-title":"Plast Reconstr Surg"},{"key":"R17-20230801","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1097\/01.PRS.0000101508.44801.F6","article-title":"Circumferential suction lipectomy of the trunk with anterior rectus fascia plication through a periumbilical incision: An alternative to conventional abdominoplasty.","volume":"113","author":"Dabb","year":"2004","journal-title":"Plast Reconstr Surg"},{"key":"R18-20230801","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1016\/j.surg.2016.05.035","article-title":"Operative correction of abdominal rectus diastasis (ARD) reduces pain and improves abdominal wall muscle strength: A randomized, prospective trial comparing retromuscular mesh repair to double-row, self-retaining sutures.","volume":"160","author":"Emanuelsson","year":"2016","journal-title":"Surgery"},{"key":"R19-20230801","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1097\/00000637-200102000-00007","article-title":"Triangular mattress suture in abdominal diastasis to prevent epigastric bulging.","volume":"46","author":"Ferreira","year":"2001","journal-title":"Ann Plast Surg"},{"key":"R20-20230801","first-page":"698","article-title":"Single-layer plication for repair of diastasis recti: The most rapid and efficient technique.","volume":"37","author":"Gama","year":"2017","journal-title":"Aesthet Surg J"},{"key":"R21-20230801","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/00000637-199602000-00012","article-title":"An evaluation of fascial staples (a new technique) in wide fascial plication during reconstructive abdominoplasty.","volume":"36","author":"Jansen","year":"1996","journal-title":"Ann Plast Surg"},{"key":"R22-20230801","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/S1090-820X(98)70088-3","article-title":"Abdominoplasty: The use of stapled Prolene mesh in severe musculoaponeurotic laxity.","volume":"18","author":"Kaddoura","year":"1998","journal-title":"Aesthet Surg J"},{"key":"R23-20230801","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s10029-013-1047-1","article-title":"Treatment of umbilical hernia and recti muscles diastasis without a periumbilical incision.","volume":"17","author":"Kulhanek","year":"2013","journal-title":"Hernia"},{"key":"R24-20230801","first-page":"183","article-title":"A novel technique of midline mesh repair for umbilical hernia associated with diastasis recti.","volume":"24","author":"Matei","year":"2014","journal-title":"Surg Technol Int"},{"key":"R25-20230801","doi-asserted-by":"crossref","first-page":"714e","DOI":"10.1097\/PRS.0b013e318267d806","article-title":"Evaluation of the long-term stability of sheath plication using absorbable sutures in 51 patients with diastasis of the recti muscles: An ultrasonographic study.","volume":"130","author":"Mestak","year":"2012","journal-title":"Plast Reconstr Surg"},{"key":"R26-20230801","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1097\/00006534-200103000-00008","article-title":"Nylon versus polydioxanone in the correction of rectus diastasis.","volume":"107","author":"Nahas","year":"2001","journal-title":"Plast Reconstr Surg"},{"key":"R27-20230801","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1097\/01.PRS.0000161675.55337.F1","article-title":"Long-term follow-up of correction of rectus diastasis.","volume":"115","author":"Nahas","year":"2005","journal-title":"Plast Reconstr Surg"},{"key":"R28-20230801","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s00266-010-9554-2","article-title":"Rectus diastasis corrected with absorbable suture: A long-term evaluation.","volume":"35","author":"Nahas","year":"2011","journal-title":"Aesthetic Plast Surg"},{"key":"R29-20230801","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1007\/s00266-004-3124-4","article-title":"Abdominoplasty: The use of polypropylene mesh to correct myoaponeurotic-layer deformity.","volume":"28","author":"Prado","year":"2004","journal-title":"Aesthetic Plast Surg"},{"key":"R30-20230801","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/00006534-200001000-00071","article-title":"Abdominoplasty and abdominal wall rehabilitation: A comprehensive approach.","volume":"105","author":"Ramirez","year":"2000","journal-title":"Plast Reconstr Surg"},{"key":"R31-20230801","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1177\/1090820X11415242","article-title":"Repair of the midline fascial defect in abdominoplasty with long-acting barbed and smooth absorbable sutures.","volume":"31","author":"Rosen","year":"2011","journal-title":"Aesthetic Surg J"},{"key":"R32-20230801","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1515\/folmed-2017-0026","article-title":"Simultaneous abdominoplasty and umbilical hernia repair via laparoscopy: A preliminary report.","volume":"59","author":"Shipkov","year":"2017","journal-title":"Folia Med (Plovdiv)"},{"key":"R33-20230801","doi-asserted-by":"crossref","first-page":"NP196","DOI":"10.1093\/asj\/sjy100","article-title":"Concomitant abdominoplasty and laparoscopic umbilical hernia repair.","volume":"38","author":"van Schalkwyk","year":"2018","journal-title":"Aesthet Surg J"},{"key":"R34-20230801","doi-asserted-by":"crossref","first-page":"e1338","DOI":"10.1097\/GOX.0000000000001338","article-title":"Lipoabdominoplasty with progressive traction sutures.","volume":"5","author":"Vera Cucchiaro","year":"2017","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"R35-20230801","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s00266-014-0272-z","article-title":"Is it possible to repair diastasis recti and shorten the aponeurosis at the same time?","volume":"38","author":"Ver\u00edssimo","year":"2014","journal-title":"Aesthetic Plast Surg"},{"key":"R36-20230801","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1097\/01.prs.0000191186.20698.0d","article-title":"Clinical outcome of abdominal wall after DIEP flap harvesting and immediate application of abdominoplasty techniques.","volume":"116","author":"Munhoz","year":"2005","journal-title":"Plast Reconstr Surg"},{"key":"R37-20230801","first-page":"105","article-title":"The effectiveness of polypropylene mesh in the open and laparoscopic repair of divarication of the recti.","volume":"1","author":"Shirah","year":"2016","journal-title":"J Med Imp Surg"},{"key":"R38-20230801","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s10029-014-1300-2","article-title":"Totally endoscopic surgery on diastasis recti associated with midline hernias: The advantages of a minimally invasive approach. Prospective cohort study.","volume":"19","author":"Bellido Luque","year":"2015","journal-title":"Hernia"},{"key":"R39-20230801","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.amsu.2018.12.002","article-title":"Endo-laparoscopic reconstruction of the abdominal wall midline with linear stapler: The THT technique. Early results of the first case series.","volume":"38","author":"Carrara","year":"2019","journal-title":"Ann Med Surg (Lond.)"},{"key":"R40-20230801","doi-asserted-by":"crossref","first-page":"252","DOI":"10.4103\/2319-4170.113374","article-title":"Assessment of videoendoscopy-assisted abdominoplasty for diastasis recti patients.","volume":"36","author":"Chang","year":"2013","journal-title":"Biomed J"},{"key":"R41-20230801","doi-asserted-by":"crossref","first-page":"e1399","DOI":"10.1590\/0102-672020180001e1399","article-title":"Subcutaneous onlay laparoscopic approach (SCOLA) for ventral hernia and rectus abdominis diastasis repair: Technical description and initial results.","volume":"31","author":"Claus","year":"2018","journal-title":"Arq Bras Cir Dig"},{"key":"R42-20230801","doi-asserted-by":"crossref","first-page":"3502","DOI":"10.1007\/s00464-018-6070-y","article-title":"Laparoscopic intracorporeal rectus aponeuroplasty (LIRA technique): A step forward in minimally invasive abdominal wall reconstruction for ventral hernia repair (LVHR).","volume":"32","author":"G\u00f3mez-Menchero","year":"2018","journal-title":"Surg Endosc"},{"key":"R43-20230801","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1097\/01.sap.0000229004.25059.87","article-title":"Endoscopic abdominoplasty: An alternative approach.","volume":"57","author":"Iglesias","year":"2006","journal-title":"Ann Plast Surg"},{"key":"R44-20230801","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1007\/s00464-018-6450-3","article-title":"Preaponeurotic endoscopic repair (REPA) of diastasis recti associated or not to midline hernias.","volume":"33","author":"Ju\u00e1rez Muas","year":"2019","journal-title":"Surg Endosc"},{"key":"R45-20230801","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s10353-017-0473-1","article-title":"Endoscopic-assisted linea alba reconstruction: New technique for treatment of symptomatic umbilical, trocar, and\/or epigastric hernias with concomitant rectus abdominis diastasis.","volume":"49","author":"K\u00f6ckerling","year":"2017","journal-title":"Eur Surg"},{"key":"R46-20230801","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1089\/lap.2018.0018","article-title":"Minimal invasive linea alba reconstruction for the treatment of umbilical and epigastric hernias with coexisting rectus abdominis diastasis.","volume":"28","author":"K\u00f6hler","year":"2018","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"R47-20230801","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1007\/s00464-018-6568-3","article-title":"Totally endoscopic sublay (TES) repair for midline ventral hernia: Surgical technique and preliminary results.","volume":"34","author":"Li","year":"2020","journal-title":"Surg Endosc"},{"key":"R48-20230801","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/s10029-008-0464-z","article-title":"Laparoscopic repair of diastasis recti using the \u2018Venetian blinds\u2019 technique of plication with prosthetic reinforcement: A retrospective study.","volume":"13","author":"Palanivelu","year":"2009","journal-title":"Hernia"},{"key":"R49-20230801","doi-asserted-by":"crossref","first-page":"62","DOI":"10.3389\/fsurg.2017.00062","article-title":"Continuous laparoscopic closure of the linea alba with barbed sutures combined with laparoscopic mesh implantation (IPOM Plus Repair) as a new technique for treatment of abdominal hernias.","volume":"4","author":"Wiessner","year":"2017","journal-title":"Front Surg"},{"key":"R50-20230801","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1097\/00006534-199808000-00037","article-title":"Endoscopic intracorporal abdominoplasty: A review of 85 cases.","volume":"102","author":"Zukowski","year":"1998","journal-title":"Plast Reconstr Surg"},{"key":"R51-20230801","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1148\/rg.341125181","article-title":"Common postoperative findings unique to laparoscopic surgery.","volume":"34","author":"Hindman","year":"2014","journal-title":"Radiographics"},{"key":"R52-20230801","doi-asserted-by":"crossref","first-page":"4934","DOI":"10.1007\/s00464-017-5607-9","article-title":"The general surgeon\u2019s perspective of rectus diastasis: A systematic review of treatment options.","volume":"31","author":"Mommers","year":"2017","journal-title":"Surg Endosc"},{"key":"R54-20230801","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1097\/00006534-200103000-00008","article-title":"Nylon versus polydioxanone in the correction of rectus diastasis.","volume":"107","author":"Nahas","year":"2001","journal-title":"Plast Reconstr Surg"},{"issue":"Suppl","key":"R55-20230801","doi-asserted-by":"crossref","first-page":"76S","DOI":"10.1177\/1090820X13499576","article-title":"Incorporating barbed sutures in abdominoplasty.","volume":"33","author":"Gutowski","year":"2013","journal-title":"Aesthet Surg J"},{"key":"R56-20230801","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1177\/1090820X11415242","article-title":"Repair of the midline fascial defect in abdominoplasty with long-acting barbed and smooth absorbable sutures.","volume":"31","author":"Rosen","year":"2011","journal-title":"Aesthet Surg J"},{"key":"R57-20230801","first-page":"698","article-title":"Single-layer plication for repair of diastasis recti: The most rapid and efficient technique.","volume":"37","author":"Gama","year":"2017","journal-title":"Aesthet Surg J"},{"key":"R58-20230801","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/00000637-199602000-00012","article-title":"An evaluation of fascial staples (a new technique) in wide fascial plication during reconstructive abdominoplasty.","volume":"36","author":"Jansen","year":"1996","journal-title":"Ann Plast Surg"},{"key":"R59-20230801","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1067\/maj.2002.124710","article-title":"\u201cMarriage\u201d abdominoplasty: A short scar technique.","volume":"22","author":"Shestak","year":"2002","journal-title":"Aesthet Surg J"}],"container-title":["Plastic &amp; Reconstructive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000007252","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T23:16:21Z","timestamp":1690931781000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PRS.0000000000007252"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,23]]},"references-count":58,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1097\/prs.0000000000007252","relation":{},"ISSN":["0032-1052"],"issn-type":[{"value":"0032-1052","type":"print"}],"subject":[],"published":{"date-parts":[[2020,10,23]]}}}