OC-078 LAP-T LAPAROSCOPIC GAS-LESS TECHNIQUE FOR THE REPAIR OF RECTUS MUSCLES DIASTASIS AND HERNIA IN ATHLETES

Abstract

Abstract Background/Aim Diastasis of Rectus Abdominis Muscles (DRAM) in athletes is typically associated with muscle and fascial tearing and fracture and umbilical/epigastric hernias. Parietal damage is generally located on midline, subjected to continuous efforts and overload. Contrarily to repair of DRAM consequent to pregnancy or obesity, in athletes, the trigger of injury will persist after repair. LAP-T Technique aims at Mini-Invasive restoration of anatomy and physiologic functionality through laparoscopic tailored suture&mesh repair, allowing return to full sport activity. Methods 96 cases from January 2010 to May 2021, minimum follow-up of 12 months. Elected patients: athletes, under 60 years old, BMI < 30, ASA1 – ASA2, with maximum IRD 10cm and associated AWR. Rectus muscles are re-approximated from xiphoid to pubis with tailored sutures, and hernia defect repaired, using laparoscopic running self-locking barbed sutures. Entire procedure is performed in gas-less laparoscopy (3mmHg). Considering persistence of triggering cause after repair in athletes, the repair is consolidated placing an intra-peritoneal mesh. 10–15 days from surgery, patients start following a tailored rehabilitation program up to full resumption of sport activity. Results In all patients, AW anatomy and physiological functionality were successfully restored, any hernia repaired, with the restitution ad integrum of the AW; no higher pain related to the continuous suturing has been reported compared to bridge IPOM laparoscopic repair, while allowing for physiologic outcome and stronger repair. No intra operative bleeding, no seroma formation, chronic pain, nor mesh infection. All athletes retrieved full sport activity at pre-hernia and DRAM level. 98% follow up at 12 months, 91% at 24, with no recurrences observed. Conclusions LAP-T technique proved to be feasible technique for Athletes, allowing for sound and anatomic reconstruction of DRAM, associated hernias, and musculo-fascial tearing, with reduced trauma, fast recovery and full resumption of sport activity.