miSAR® is a minimally invasive abdominal wall reconstruction technique indicated in selected patients with rectus diastasis and midline defects.
It is not, however, a “universal” technique: the choice depends on
- Ianatomy of the abdominal wall
- IItype of defect
- IIIprevious surgery
- IVthe individual patient’s characteristics
The right question is
“which reconstruction best suits my abdominal wall?”
Main indications
miSAR® may be considered in the presence of:
- 01rectus diastasis
- 02umbilical hernia associated with diastasis
- 03epigastric hernia associated with diastasis
- 04primary midline hernias
- 05selected midline incisional hernias
- 06multiple midline defects
It is particularly useful when the aim is not only to close a single defect, but to reconstruct the entire midline.
How large can the defect be?
Studies carried out during 5-year follow-up identified 2 possible limits:
> 6cm
defect size
> 26BMI
body mass index
≈ 0%recurrence
With correct patient selection, a recurrence rate close to 0% can be achieved
Diastasis and hernia together
This is one of the situations in which miSAR® may be most indicated.
When an umbilical or epigastric hernia is associated with diastasis, treating only the hernia opening may not be enough in some patients.
miSAR® makes it possible to address in the same operation:
What if lateral diastasis is also present?
The assessment must also include the semilunar lines and the lateral compartments.
Some posterior reconstructions, including miSAR®, can medialise the lateral musculature, helping to restore abdominal wall tension and the waistline.
In combined defects the strategy is therefore planned to correct both the midline and the lateral component.
Learn moreLateral diastasismiSAR® or p-miSAR®?
When anatomy allows, the p-miSAR® variant can be used, which carries out the reconstruction through the preperitoneal/extraperitoneal plane.
The principle remains the same
reconstruct the midline and place the mesh in a deep, protected anatomical plane.
Limit of p-miSAR®
Difficulty in developing the preperitoneal plane in patients with previous caesarean sections
Frequently asked questions
Is miSAR® indicated for every diastasis?
No. The indication depends on the characteristics of the diastasis, the presence of hernias and the overall anatomy of the abdominal wall.
Can it also be used for an umbilical hernia?
Yes, especially when the hernia is associated with rectus diastasis.
Can it be used for an incisional hernia?
In selected midline incisional hernias yes, but in more complex defects another reconstruction may be preferable.
Does the size of the diastasis alone determine the technique?
No. The choice also depends on associated defects, tissue quality, previous surgery, BMI and the shape of the abdominal wall.
Would you like to know whether miSAR® is right for you?
A specialist consultation makes it possible to assess diastasis, hernias, abdominal wall quality and previous surgery, and to choose the most appropriate technique.