Introduction: The technique used for correction of rectus
abdominis diastasis has been a debatable issue since the
original description of abdominoplasty. The aim of this study
is to assess the durability of the correction of midline diastases
done by two different techniques (the rectus abdominis myofascial
release technique and the conventional midline plication)
and their effect on waist enhancement and its safety in
the terms of the intraabdominal pressure changes and respiratory
affection that occur after plication.
Patients and Methods: The study was conducted on 12
females with body mass index less than 30, having Rohrich
type IV B deformities. The patients were divided randomly
into two groups based on the technique used for plication of
anterior rectus sheath: Group (A) 6 patients underwent myofascial
release technique, while group (B) 6 patients underwent
conventional midline plication. The two groups were compared
as regards; 1- The width of rectus diastasis using computed
tomography of their anterior rectus abdominis sheath pre-and
post-operatively at 1 and 6 and as regards 3 points: (A) At
the umbilicus, (B) Midway between umbilicus and xiphoid
process and (C) Midway between umbilicus and symphysis
pubis 2- Waist hip ratio pre-and post-operatively at 1 and 6
months. 3- Evaluation of ventilatory function using spirometry
and intraoperative measurement of intra-abdominal pressure
before and after plication.
Results: Post-operative follow-up time averaged 8 months
(range 6-10 months). Group A showed significant decline in
the diastasis distance and increase in WHR than group B.
There was a significant reduction in spirometry values and
increase in IAP in group A rather than group B after surgery
but there was no clinical differences in the respiratory function
between both groups.
Conclusion: Plication of the anterior rectus sheath using
myofascial repair technique showing nonsignificant residual
diastasis six months post operatively and has a better effect
on the waist enhancement than the conventional plication
with no respiratory complication.