How can a umbilical hernia be repaired correctly without fixing diastasis recti?

Umbilical hernias are quite common and occur in the setting of a previous surgery, pregnancy, or diastasis recti. We treat umbilical hernias with or without correction of diastasis recti using a combination approach that corrects redundant skin in the lower abdomen and around the belly button. If there is a lot of skin, we would use a tummy tuck scar whereas smaller corrections can be performed using just the belly button incision which is well hidden inside your belly button.


Best,
Dr. Karamanoukian
Realself100 Surgeon

A diastasis and a hernia are not the same thing. A hernia is a hole in the connective tissue while a diastasis is stretching of the connective tissue. The hole can be fixed with or without mesh, although mesh reduces the risk of recurrence and is usually the preferred method of repair. Repairing the hernia only repairs the hole. Repairing a diastasis requires partial reconstruction of the abdominal wall, usually by "imbricating" the connective tissue and then reinforcing with mesh. This still does not treat the underlying problem which is usually genetic. Fixing the hernia has nothing to do with the diastasis and you will still have bulging along the midline of the abdominal wall. I hope this helps.

An umbilical hernia is a defect in the fascia (connective tissue) near the belly button, which can be painful and poses a health risk if the bulging contents from inside the abdominal wall get stuck inside this defect.  Diastasis recti is separation of the "six-pack" rectus abdominis muscles; as the space between the muscles widens, there may be some bulging, but there is no fascial defect for contents to get stuck.  I would recommend discussing in more detail with your surgeon the differences between the two conditions and the various options that are available to correct each.
Ziyad Hammoudeh, MD