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NYC Hernia

Hernia Repair in New York City by Brian Jacob, MD

  • About Dr. Jacob
    • Dr. Brian P. Jacob, MD, FACS
    • In The News
    • Publications/Research
    • Blog
  • Hernia Procedures
    • Inguinal Hernia
    • Diastasis Recti
    • Femoral Hernia
    • Parastomal Hernia
    • Umbilical Hernia
    • Ventral/Incisional Hernia
  • Groin Pain & Injuries
    • Chronic Groin Pain
    • Mesh Pain and Mesh Removal
    • Hidden (Occult) Hernia
    • Recurrent Hernia
    • Sports Hernia or Athletic Pubalgia
    • Adductor Longus Sprains and Tears (Athletic Pubalgia)
    • Acnes (Anterior Cutaneous Nerve Entrapment Syndrome)
  • Weight Loss Surgery
    • Sleeve Gastrectomy
    • Revisional Weight Loss Surgery
    • Adolescent Sleeve Gastrectomy
  • Patient Journey
    • Initial Office Visit
    • Preparing for Surgery
    • Insurance and Financing
    • Risks Associated With Laparoscopic Inguinal Hernia Surgery
    • Recovery After Inguinal Hernia Surgery
    • Inguinal Hernia Surgery – Discharge Instructions

Diastasis Recti

Dr. Brian Jacob in NYC performs a non mesh laparoscopic diastasis recti repair on very select patients.

Before and After Diastasis Surgery by Dr. Jacob

Before diastasis surgery
Diastasis Recti: before surgery
After laparoscopic diastasis surgery by Dr. Jacob
After laparoscopic diastasis surgery by Dr. Jacob

What Is Diastasis Recti?

A diastasis of the abdominal wall , (diastasis recti), is not a hernia.  Clinically, a diastasis may look like a hernia in the sense that when the abdomen is flexed, there is a noticeable and cosmetically unpleasing bulge, usually located in the upper abdomen in the midline, above your belly button.  But there is a big difference.  A hernia is a hole in the fascia.  A diastasis is just stretched out midline fascia, and not a real hernia.  Thus a diastasis has no real incidence of developing an emergent incarceration or strangulation.  A diastasis, with stretched out midline fascia, results in your two rectus muscles being far apart.

How Do I Know If I Have Diastasis Recti?

Diastasis recti can present as a bulge or pain (or both) in your abdomen.   Abdominal wall function weakness is a common symptom, and has often been reported as improved after diastasis repair.  However , despite being symptomatic, a diastasis repair alone is still considered elective, cosmetic, and is therefore not reimbursed by most insurance companies.

No Mesh Laparoscopic Diastasis Recti Repair

Dr. Brian Jacob offers a minimally invasive (laparoscopic) non-mesh diastasis repair.   The procedure has been vetted and accepted by colleagues internationally.  There is no skin excision, which is a big difference from a traditional plastic surgery abdominoplasty.  This surgery is only offered to select patients.  Please discuss all of the risks, expectations, and potential benefits with your surgeon.  Recurrent diastasis recti and hernia formation is possible.  Seromas are possible.  Cosmetic results can not always be guaranteed.  This surgical video may contain graphic surgical images for mature audiences only.   It is designed with the sole intent to educate other surgeons.

How Do I Know If I Need Surgery?

If you think you have a diastasis recti, then make an appointment with a hernia expert or a plastic surgeon to discuss your options.  Most diastasis do NOT require surgery.  Some surgeons are using minimally invasive approaches (laparoscopy and robotics) to suture close the stretched out fascia and thus reapproximate the rectus muscles.  Insurance usually does not cover this procedure since technically this is not a hernia repair.  Each case needs to be individualized.  Most surgeons would recommend nonoperative attempts that include weight reduction and physical therapy.  Specific physical therapy programs may exist in your region.

Imaging for diastasis recti is sometimes useful and your surgeon may order a CTSCAN.  This CTSCAN can identify the extent and size of the diastasis, and can be used to accurately measure how far apart your rectus muscles are, and confirm that it is not a hernia.  Some patients have small hernias, or an umbilical hernia, within the diastasis.

How Is Diastasis Repaired?

Repair options for diastasis recti include:

  • no surgery.  Trial of time and / or physical therapy.
  • open primary repair (often done by a plastic surgeon at the same time as an abdominoplasty to removed excess skin)
  • open mesh repair (This is rarely done or needed for primary diastasis).
  • laparoscopic or robotic diastasis suture repair with or without mesh reinforcement.  If mesh is used, then suture fixation, tack fixation, or a combination are common.  The main objective here is to use a suture to reapproximate your rectus muscles to the midline.
  • Dr. Jacob offers a laparoscopic repair of diastasis without mesh for select cases.

Are There Risks To Diastasis Surgery?

Some surgical risks include, but are not limited to:

Recurrences, chronic pain, bowel obstruction, enterotomy, mesh erosion, fistula, seroma, hematoma, and infection.

Surgical Preparation

Patients with obesity (BMI greater than 35) should try to lose weight to keep a body mass index less than 35 if possible.  If you have obesity, it is not advised to have a diastasis repair as the recurrence rates are quite high.

Patients must quit smoking prior to any surgery.

Schedule A Consultation

To learn more about diastasis recti, please call our office today to schedule an appointment.

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Address & Info

Laparoscopic Surgical Center of New York
1010 5th Avenue
New York, New York 10028 United States
+1 212-879-6677
nychernia@gmail.com
Office Hours are 9:30am - 5pm, Monday - Friday

Dr Vine sees patients on Mondays
Dr. Katz sees patients on Tuesdays
Dr. Jacob sees patients on Wednesdays

Copyright © 2021 Brian Jacob, MD. All rights reserved.

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