Classification of Rectus Diastasis—A Proposal by the German Hernia Society (DHG) and the International Endohernia Society (IEHS)

Frontiers in Surgery

article

Wolfgang Reinpold¹  Bernd Stechemesser²  Ferdinand Köckerling³  Reinhard Bittner⁴  Joachim Conze²  René Fortelny⁵  Andreas Koch⁶  Jan Kukleta⁷  Andreas Kuthe⁸  Ralph Lorenz⁶ 

[1] Wilhelmsburger Krankenhaus Groß-Sand;Hernienzentrum Köln;Department of Surgery, Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital;Marienhospital Stuttgart;Department of General Surgery, Medical Faculty, Wilhelminen Hospital, Sigmund Freud University;Hernia Center Cottbus;Visceral Surgery Zurich;DRK-Krankenhaus Clementinenhaus

关键词: rectus diastasis;    classification;    concomitant hernia;    pregnancy;    defect width;   

DOI  :  10.3389/fsurg.2019.00001

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction: Recently, the promising results of new procedures for the treatment of rectus diastasis with concomitant hernias using extraperitoneal mesh placement and anatomical restoration of the linea alba were published. To date, there is no recognized classification of rectus diastasis (RD) with concomitant hernias. This is urgently needed for comparative assessment of new surgical techniques. A working group of the German Hernia Society (DHG) and the International Endohernia Society (IEHS) set itself the task of devising such a classification. Materials and Methods: A systematic search of the available literature was performed up to October 2018 using Medline, PubMed, Scopus, Embase, Springer Link, and the Cochrane Library. A meeting of the working group was held in May 2018 in Hamburg. For the present analysis 30 publications were identified as relevant. Results: In addition to the usual patient- and technique-related influencing factors on the outcome of hernia surgery, a typical means of rectus diastasis classification and diagnosis should be devised. Here the length of the rectus diastasis should be classified in terms of the respective subxiphoidal, epigastric, umbilical, infraumbilical, and suprapubic sectors affected as well as by the width in centimeters, whereby W1 5 cm. Furthermore, gender, the concomitant hernias, previous abdominal surgery, number of pregnancies and multiple births, spontaneous birth or caesarian section, skin condition, diagnostic procedures and preoperative pain rate and localization of pain should be recorded. Conclusion: Such a unique classification is needed for assessment of the treatment results in patients with RD.

【 授权许可】

CC BY