What does abdominal fascial plication and open ventral hernia repair mean?

Question

I was diagnosed via CT scan with a severe case of diastasis of the muscle, with loss of muscle tone, and it's causing my intestines to buldge out as if I have a huge ventral hernia. My surgeons are going to do either an open ventral hernia repair or abdominal fascial plication. Can someone tell me what are these procedures?

Jeffrey E. Schreiber, MD, FACS · Answer

Fascial plication is tightening the abdominal muscles.  This can be done at the same time as a tummy tuck.

Dean Trotter, MBBS, FRACS · Answer

It sounds like you have a rectus diastasis - this is where your rectus abdominus muscles (your "six-pack" muscles) separate in the midline.  This causes a weakness in the midline where your intra-abdominal contents (i.e. your intestines) can bulge out - this is also known as a ventral hernia.  This is common in women who have had large babies or twins, especially if they have a narrow pelvis and carry their baby "high".  This rectus diastasis/ventral hernia is generally not able to be fully corrected with exercise or physiotherapy.  Apart from the cosmetic issue of midline bulging, it can be associated with back or abdominal pain and even urinary incontinence and chronic constipation.Repair of the rectus diastasis usually involves fascial plication - this is where the strong fascial (connective) tissues of the abdominal wall are brought back together in the midline.  This is usually possible just with sutures but sometimes a mesh is required.  Most commonly this is performed as part of a tummy tuck (abdominoplasty) which will allow any associated loose skin to be removed and also provides excellent access to facilitate a really strong and lasting repair.I hope this helps your understanding.Kind regards,Dean

Adolfo Sesto, MD · Answer

Hi. As they told your condition is the opening of the fascia of the abdominal wall. The "Open Ventral Hernia Technique" consists in making an incision that comes vertically up and down  in your abdomen for repairing purposes, with a bad  aesthetic result, under my humble opinion.Instead, the "Abdominal Fascia Plication " consists in a Tummy Tuck (a bikini line incision ) through which we can close the Ventral Diastasis with Plication, and also place a non absorbable net of polipropilene to reinforce the abdominal wall.At the end of this procedure you will have a normal abdominal shape, and better aesthetic results.

Melinda Lirag Lacerna-Kimbrell, MD, FACS · Answer

Plication is when the fascia on either sides of the weakened muscles are stitched together to recreate stability. Essentially the ventral hernia repair is the same, but if the lining is thinned enough or too much your surgeons may reinforce the area with a mesh product.Thank you for your question!Melinda Lacerna, MD FACS

Steven Wallach, MD · Answer

A real ventral hernia likely needs repair with some sort of mesh.  A fascial plication usually refers to an imbrication of two sides of fascia. This is commonly done during a tummy tuck to tighten the abdomen in the midline.

Vasdev Rai, MD · Answer

Abdominal fascial plication repairs your diastasis and ventral hernia.  So both terms are referring to same goal.  Do discuss with your own surgeon so you can understand your operation more clearly.  Face to face interaction is more meaningful in understanding technical issues of surgeryi

Paul J. Leahy, MD · Answer

Thank you for your question. Pregnancy is the typical cause of diastasis of the abdominal wall, which means a thinning and stretching of the thick connective tissue (fascia) between the two major abdominal muscles (the rectus abdominis muscles--responsible for the "six pack"). A hernia, by definition, is an actual hole or defect in that fascia. Both can exist at the same time. Typically, a general surgeon would be involved in a large hernia repair, while the plastic surgeon can manage the diastasis by using sutures to bring the muscles back into the appropriate location. Talk w/ your surgeon(s) about which is best for you.

What does abdominal fascial plication and open ventral hernia repair mean?

Answers (7)

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