Diastasis repair with umbilical hernia repair, Raleigh, NC*

This 38 year old mother of 3 children developed marked diastasis recti and umbilical hernia after her pregnancies. Diastasis repair is the normal part of an abdominoplasty.. She was very slender and could not improve her protruding abdomen with exercise. She underwent a combined diastasis repair and direct repair of the umbilical hernia done via a mini abdominoplasty technique. The anterior abdominal wall is approached from the suprapubic area ( via an incision about the size of a C section scar). The umbilicus is "floated" ( released and left intact with the abdominal wall). The defect in the umbilicus is directly repaired with permanent suture and the diastasis is repaired by plication with two separate layers of non absorbable sutures closing the gap in the rectus muscles. The umbilicus is sutured back to the abdominal wall in its original location and a small amount of excess skin is removed from the lower abdominal incision to tighten the abdominal skin. She was very happy with the result. She now had a flat abdomen and the hernia was fixed. The umbilicus was slightly widened-( it had been quite stretched out preoperatively)- this can be corrected with a minor revision if necessary but the patient was so pleased that she decided she didn't need it..