A Novel Robotic Approach for the Repair of Abdominal Wall Hernias With Concomitant Diastasis Recti: Outcomes and Long-term Follow-up

Abstract

Background: Diastasis recti (DR) is defined as the separation of the rectus muscles as a result of the linea alba thinning and stretching. The purpose of this study was to evaluate the long-term outcomes of a new technique, robotic rectus abdominis medialization (rRAM), for DR repair with a concomitant ventral hernia. Methods: Patients who underwent rRAM for repair of DR and a concomitant ventral hernia were identified between January 2015 and December 2020. The results are from a single surgeon at a single institution. Results: A total of 40 patients were identified, 29 of which were female. The mean age was 43 years, the mean body mass index was 27 kg/m2, and the mean inter-rectus distance was 6 cm based on available preoperative imaging. The median postoperative length of stay was 1 day, and the median follow-up time was 1 month. Within 30 postoperative days, 3 patients were re-admitted and 5 developed complications, of which 1 required operative re-intervention for seroma. Beyond 30 days, 3 patients required operative re-intervention most commonly for persistent pain from suture material. On the basis of computed tomography scans performed at a mean of 30 months after the date of service, the mean postoperative inter-rectus distance was 1 cm; 1 patient had DR recurrence, and 1 patient developed a new incisional hernia without DR recurrence. There was no hernia recurrence. Conclusions: rRAM is a safe and effective technique for DR repair with a concomitant ventral hernia. Further studies are needed to determine how outcomes from this robotic approach compare with those from different robotic, laparoscopic, and open techniques.