V-051 SCOLA TECHNIQUE WITH PERIUMBILICAL MINI-INCISION FOR UMBILICAL HERNIA WITH BIG DIASTASIS RECTI: A CASE REPORT

Abstract

Abstract Background Diastasis of the rectus abdominis muscles (DRAM) is frequent and may be associated with abdominal wall hernias. In 2017 subcutaneous onlay laparoscopic approach (SCOLA) was described which combines diastasis recti plication and abdominal wall hernia repair without requiring a great incisions nor skin resections. Objective To show a video of a SCOLA technique with open periumbilical dissection through 2.5 cm periumbilical mini-incision. The aim is to reduce operative time and to improve the quality of life with good aesthetic results by a minimal invasive procedure. Method We report a case of a 39 years old woman with 3 previous caesarian deliveries, diagnosed with umbilical hernia and diastasis recti with a 95mm internal gap. The patient was scheduled electively for a SCOLA technique. Results Surgery was performed with no intraoperative complications. Persistent hematic output through drains was seen first 24h postoperatively which required blood transfusion for anemization, but no need for reoperation, correct hemoglobin controls afterward. Small hematoma detected in 1st month control, with correct resolution on 4th month control. No recurrence of umbilical hernia nor diastasis recti observed during this short follow-up. Conclusion SCOLA technique has been proven to be a reproductive and secure technique for those patients with DRAM associated with abdominal wall hernia that do not require nor need skin resection or great incisions. The aim of the periumbilical dissection through mini-incision is to decrease surgical time. One must consider the risk of bleeding or seroma associated with the extensive dissection in cases with great diastasis gap.