REPARACIÓN ENDOSCÓPICA PRE-APONEURÓTICA (REPA) PARA DIÁSTASIS DE RECTOS: SERIE INICIAL DE CASOS Y ANÁLISIS CLÍNICO
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Rev. Méd. La Paz
Abstract
Introducción. La diástasis de rectos abdominales (DRA) es una condición frecuente, especialmente en mujeres posparto, caracterizada por la separación de los músculos rectos abdominales. Puede asociarse a hernias de la línea media y generar síntomas funcionales importantes. La técnica de Reparación Endoscópica Pre-Aponeurótica (REPA) es una alternativa mínimamente invasiva que evita el acceso intraperitoneal, reduciendo riesgos asociados a las mallas internas. El objetivo de este estudio fue evaluar la seguridad y efectividad de la técnica REPA para el tratamiento de la DRA, describiendo los resultados clínicos y quirúrgicos de una serie inicial de casos. Material y Métodos: Se realizó un estudio descriptivo y retrospectivo basado en historias clínicas de 12 pacientes operadas entre 2022 y 2024 en un hospital de segundo nivel en La Paz, Bolivia. Se incluyeron pacientes con DRA, asociada o no a hernias de línea media. Resultados: Se analizaron 12 casos, todas mujeres, con edad promedio de 35 años e IMC medio de 24,6 kg/m2. Todas presentaban DRA asociada a hernias umbilicales menores a 4 cm. La diástasis promedio fue de 38 mm. El tiempo quirúrgico medio fue de 164 minutos y la estancia hospitalaria promedio fue de 2 días. No se reportaron complicaciones como seroma, hematoma o infecciones. Conclusiones: La técnica REPA demostró ser segura y efectiva en esta serie inicial, con buenos resultados estéticos y funcionales y una baja tasa de complicaciones. Su aplicación en hospitales de segundo nivel parece viable y reproducible.
Introduction. Rectus abdominis diastasis (RAD) is a common condition, particularly in postpartum women, characterized by the separation of the rectus abdominis muscles. It may be associated with midline hernias and cause significant functional symptoms. The Preaponeurotic Endoscopic Repair (REPA) technique is a minimally invasive alternative that avoids intraperitoneal access, thereby reducing the risks associated with intraperitoneal meshes. The aim of this study was to evaluate the safety and effectiveness of the REPA technique for the treatment of RAD, describing the clinical and surgical outcomes of an initial case series. Materials and Methods: A descriptive, retrospective study was conducted based on the medical records of 12 patients operated between 2022 and 2024 at a second-level hospital in La Paz, Bolivia. Patients with RAD, with or without associated midline hernias, were included. Results: Twelve cases were analyzed, all female, with a mean age of 35years and a mean BMI of 24.6 kg/m2. All presented RAD associated with umbilical hernias smaller than 4 cm. The average diastasis width was 38 mm. The mean operative time was 164 minutes, and the mean hospital stay was 2 days. No complications such as seroma, hematoma, or infection were reported. Conclusions: The REPA technique proved to be safe and effective in this initial series, providing good aesthetic and functional outcomes with a low complication rate. Its implementation in second-level hospitals appears feasible and reproducible.
Introduction. Rectus abdominis diastasis (RAD) is a common condition, particularly in postpartum women, characterized by the separation of the rectus abdominis muscles. It may be associated with midline hernias and cause significant functional symptoms. The Preaponeurotic Endoscopic Repair (REPA) technique is a minimally invasive alternative that avoids intraperitoneal access, thereby reducing the risks associated with intraperitoneal meshes. The aim of this study was to evaluate the safety and effectiveness of the REPA technique for the treatment of RAD, describing the clinical and surgical outcomes of an initial case series. Materials and Methods: A descriptive, retrospective study was conducted based on the medical records of 12 patients operated between 2022 and 2024 at a second-level hospital in La Paz, Bolivia. Patients with RAD, with or without associated midline hernias, were included. Results: Twelve cases were analyzed, all female, with a mean age of 35years and a mean BMI of 24.6 kg/m2. All presented RAD associated with umbilical hernias smaller than 4 cm. The average diastasis width was 38 mm. The mean operative time was 164 minutes, and the mean hospital stay was 2 days. No complications such as seroma, hematoma, or infection were reported. Conclusions: The REPA technique proved to be safe and effective in this initial series, providing good aesthetic and functional outcomes with a low complication rate. Its implementation in second-level hospitals appears feasible and reproducible.
Description
Vol. 31, No. 2