Abdominal diastasis can recur even after surgery. Recurrence means that excessive separation of the rectus abdominis muscles reappears after a previous correction.
failure of the repair
orprogressive widening of the linea alba.
How can you tell if diastasis has come back?
A recurrence can show itself through changes in the appearance of the abdomen or through the return of functional symptoms that were present before surgery.
The most common signs include:
Return of the central bulge,especially during effort or abdominal contraction.
Change in the abdominal profile,with loss of the result previously achieved.
A feeling of weakness in the abdominal wall,or difficulty managing effort.
Return of functional symptoms,such as reduced trunk stability and difficulty with daily activities.
These symptoms do not necessarily prove a recurrence. After surgery, changes in the abdominal profile or functional symptoms can appear even without a new separation of the rectus muscles.
This is why it is important to distinguish clinical suspicion from anatomical confirmation.
How is recurrent diastasis diagnosed?
Diagnosis begins with a specialist consultation and an assessment of the abdominal wall during muscle contraction.
When diagnostic confirmation is needed:
CT scan of the abdominal wall,
possibly with a Valsalva manoeuvre or bearing down.
Magnetic resonance imaging,
including dynamic assessment where available.
Without contrastThese scans can generally be performed without contrast when the aim is to study the abdominal wall and there are no other clinical indications.
They make it possible to assess the distance between the rectus muscles, any associated hernias and the characteristics of the previous repair.
- distance between the rectus muscles
- associated hernias
- previous repair
Why can diastasis recur?
The risk of recurrence depends on several factors, including:
Related to surgery
- The surgical technique used in the first procedure.
- Strength of the fascial tissues.
- Method of reconstruction and whether mesh reinforcement was used.
Related to the patient
- Individual factors that increase stress on the abdominal wall.
- Returning to sport and heavy physical activity too quickly
- Weight gain after surgery
Minimally invasive treatment of recurrent abdominal diastasis
Even a previously operated diastasis can be treated, in selected cases, with minimally invasive laparoscopic or robotic techniques.
The procedure may include:
- Reconstruction of the midline and restoration of the anatomical relationships of the wall.
- Correction of any associated hernias.
- Placement of a reinforcing mesh to support the reconstruction.
- Use of appropriate anatomical planes to reduce contact between the mesh and the abdominal organs.
The approach must be personalised according to
- the previous surgical technique
- the size of the recurrence
- tissue characteristics
Can an existing mesh be removed?
Yes, in some cases a previously implanted mesh can be removed.
Whether it can be removed depends mainly on:
- The anatomical plane in which it was placed.
- The type of mesh and how well it has integrated into the tissues.
- The presence of adhesions.
- Any associated complications.
- Whether it needs to be removed to perform a new reconstruction.
Removing the old mesh is not always necessary: when it causes no problems and does not interfere with the new reconstruction, it may be better to leave it in place.
Has your diastasis come back after surgery?
Even recurrent diastasis can be treated with minimally invasive techniques.
A specialist assessment makes it possible to study the previous repair and plan a stable, personalised reconstruction.
Frequently asked questions
Can diastasis come back after surgery?
Yes. A recurrence can occur even after previous surgical correction. The risk depends on the technique used, tissue quality and other individual factors.
How can I tell if my diastasis has come back?
The return of the abdominal bulge or of previous functional symptoms may suggest a recurrence. Confirmation requires a specialist assessment and, where appropriate, imaging.
Is a contrast-enhanced CT scan needed?
Generally not. For the anatomical study of the abdominal wall, a CT or MRI without contrast may be sufficient, possibly while bearing down, as indicated by the specialist.
Can recurrent diastasis be operated on laparoscopically?
Yes, a new minimally invasive laparoscopic or robotic reconstruction is possible.