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Endoscopic assisted linea alba reconstruction (ELAR) : Our experience

Ajay Bhandarwar, MS, FMAS, FIAGES, FAIS, FICS, FBMS1, Girish D Bakhshi, MS, MRCS2, Shivang D Shukla, MBBS1, Amol N Wagh, MS, FMAS, FIAGES, FAIS, FICS, FBMS1, Shekhar A Jadhav, MS, FMAS1, Amarjeet E Tandur, MS1, Jalbaji More, MS1, Nidhisha Sadhwani, MBBS1, Priyanka Saha, MBBS1, Khushboo Kadakia, MBBS1. 1Grant Government Medical College & Sir J.J. Group of Hospitals, Mumbai, India, 2Grant Govt. Medical College & Sir J. J. Group of Hospitals, Byculla,,Maharashtra, India

Introduction: Diastasis of recti is separation of two sides of rectus abdominis muscle.

It has more prevalence in newborns and postpartum women.

It usually occurs due to stretching of criss cross fibres of line alba due to stretching of abdomen under combined with effects of relaxin in postpartum women.

Material and methods: In our tertiary care set up , we operated 5 cases of diastasis of recti through endoscopic plication with or without onlay mesh.

Diagnosis was made by BEER classification by placing ultrasound probe on xiphoid sternum , 2 cms above it and 3 cms below.

One 10mm port was inserted above pubis symphysis and two 5mm working ports were placed 5cms on either side. Meticulous dissection was performed upto 3 cm laterally from mid line so as to avoid skin necrosis. Plication of recti was done from pubic symphysis upto xiphoid sternum using non absorbable sutures in a continuous fashion. Umbilicus was hitched to fascia for cosmesis

An onlay mesh was placed in 5 patients

A subcutaneous drain was inserted so as to avoid seroma formation. Skin was closed using non absorbable sutures.

Technique details and outcomes will be discussed.

Results:

Average post operative time was – 80 min

average time for resumption of diet : evening of surgery.

Average post operative stay : 3 days

Average time for removal of drain < 20 cc : 1.5 days

Patients were followed up after 3 months.

Pain was assessed on visual analogue scale. (0-10)

Recurrence was objectified on using using beer classification.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 94097

Program Number: P580

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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