News - 22/03/2022
MISAR: AN INNOVATIVE TECHNIQUE FOR THE TREATMENT OF DIASTASIS
For the treatment of diastasis, there is a new, very innovative, minimally invasive technique which aims to restore the original anatomical conditions of the abdominal wall.
The other existing techniques, minimally invasive and via the classic route, reduce the diastasis by performing a suture that binds the two rectus muscles together (anterior muscles of the abdomen). This technique alters the original anatomy of the abdominal wall and is associated with a longer period of recovery.
MISAR (Minimally Invasive Stapled Abdominal Reconstruction) treats diastasis by reconstructing the white line (also called the midline), which is an aponeurotic structure, identically to its pre-diastatic conditions by connecting the two rectus muscles. They thus retain their anatomical and functional independence.
In a recent study, this technique has already shown very good results, with a high success rate and a regression of diastasis-related symptoms in about 90% of cases.
Diastasis (meaning "separation") is characterized by a relaxation of the abdominal white line muscles (aponeurosis or fascia that unite the anterior muscles of the abdomen, rectus abdominis). Unlike hernias, there is no hole in the aponeurosis.
These 2 muscles are located in the middle of the abdomen vertically, stretched from the lower part of the sternum to the upper part of the pubic symphysis. In some cases, they can move apart, creating diastasis. The wall of the abdomen then rises under the abdominal thrust.
We speak of diastasis if the distance between the rectus muscles is greater than 2 cm.
Several cases can occur:
It occurs more frequently after pregnancy, but obesity or a history of abdominal surgery can also favor its appearance.
• In men, it sits above the umbilicus. When the patient goes from the lying position to the sitting position, a significant arch forms like a wave between the sternum and the navel, it is generally overweight men, willingly former athletes. No surgical treatment, only weight loss can reduce diastasis.
• In overweight women, there is always a diastasis of the abdominal wall, it is more or less important depending on the overweight and it can only be corrected by a surgical intervention associating lipectomy and muscular approximation. When diastasis is due to obesity, the obesity must first be treated, either medically or surgically.
• In thin women, a diastasis can occur after one or more pregnancies, it follows the distension of the anterior wall of the abdomen by a pregnant uterus. The problem is then essentially aesthetic, physiotherapy and massages are ineffective, the treatment becomes surgical.
Umbilical and epigastric hernias are often associated with diastasis because of the progressive laxity of the linea alba. Surgery must correct the diastasis at the same time as the hernia, because the risk of recurrence is higher if the hernia alone is treated.
- Diastasis can also be accompanied by abdominal pain on exertion. It can favor the appearance of lower back pain, especially if accompanied by excessive weight.
- Diastasis can also disrupt the pelvic muscles and cause urinary or gynecological incontinence issues (pelvic prolapse).
Warning ! Aggressive abdominal exercise can contribute to the development of diastasis.
♦ To make an appointment with Dr. Bruto Randone, ENGLISH SPEAKING Visceral and Digestive Surgeon, at the Clinique Internationale du Parc Monceau, 21 Rue de Chazelles, 75017 Paris, France, or at the Clinique Bizet, 23 Rue Georges Bizet, 75116 Paris, France, click on Contact.
