How long does it take to recover after a mesh repair of divarication?
Unlike most other hernia repairs, it is a more major undertaking and requires an average hospital stay of 5 days. You may not be able to return to work for about two weeks. Your ability to drive a car is governed by being able to put your right foot on the brake pedal to perform an emergency stop without inhibition (automatic transmissions) or both feet on the clutch and brake pedals (manual transmissions). Avoidance of heavy lifting or straining for three months is recommended to allow the tissues to reach their maximal tensile strength and therefore reduce the risk of recurrence.
Divarication of Recti
Divarication of recti, also known as diastasis recti, arise from a generalised stretching of the linea alba in the midline fibrous tissue between the bottom of the rib cage and the pelvis which in turn causes a splitting of the rectus muscles (the ‘six pack’) laterally away from the midline. This can be associated with being over-weight or can commonly occur after pregnancy. The separation of the rectus muscles usually occurs above or below the umbilicus and infrequently in both areas.
What are the signs and symptoms?
Often patients have few symptoms except for a dull ache or dragging sensation in the area of divarication. Patients often notice a progressively enlarging bulge in the midline.
Does divarication of recti / diastasis recti need surgery?
No. It does not usually require an operation, but surgery is recommended when there is pain or discomfort, the diffuse bulge is gradually enlarging, or if the separation is cosmetically unacceptable.
What are the surgical / treatment options?
A tension free open mesh repair is the optimal method of repair advocated by the Hong Kong Hernia Center's specialists with the lowest incidence of recurrence. The mesh is placed in the preperitoneal plane to avoid the mesh sticking to the intestines. The rectus muscles are then re-approximated (plicated together) to one another with sutures. While there is a laparoscopic method of repairing this defect which is less invasive, there have been no randomised studies published thus far to demonstrate this a better way of repairing this type of hernia. Secondly, the placement of an intraperitoneal non-adherent mesh does not allow for re-approximation of the rectus muscles to one another.