Post-pregnancy belly repair

All patients who visit the Maria Middelares Hernia Centre in Ghent with a post-pregnancy belly are seen by the abdominal surgeon and the plastic surgeon. They will determine, with the patient, if a surgical procedure is advisable. We will also have an ultrasound done to measure the distance between the rectus abdominal muscles and to determine the severity of the diastasis recti.

A post-pregnancy belly is corrected by removing redundant skin through abdominoplasty and by repairing the diastasis using sutures placed by the plastic surgeon. If the ultrasound indicates that the diastasis recti is more than four centimetres or if an umbilical hernia is seen, the abdominal wall will be reinforced during the procedure by the abdominal surgeon placing a mesh between the different muscle layers.

Robot-assisted laparoscopic repair of diastasis recti

Some women with a post-pregnancy belly have no clearly redundant skin and therefore do not require abdominoplasty. These patients can be treated with keyhole surgery.

In September 2016, the Maria Middelares Hernia Centre in Ghent was the first European centre to offer robot-assisted laparoscopic hernia repair. The procedure is essentially the same as the traditional laparoscopy, but the instruments and the camera are operated by the surgeon from a console. At the Maria Middelares Hernia Centre in Ghent, we use the latest generation of the Intuitive DaVinci Xi robot. Dr Muysoms now trains European surgeons in this latest innovation in abdominal wall surgery. Together with other surgeons performing robot-assisted repair od diastasis recti, an innovative technique was developed at the Maria Middelares Hernia Centre in Ghent, where the prosthesis is not placed in the abdomen but between the different muscle layers. This new technique, termed TARUP (trans abdominal retromuscular umbilical prosthesis), retains the advantages of keyhole surgery but avoids placing the prosthesis so that it comes into contact with the bowels and avoids the painful fastening using staples.

Diastasis recti surgery is generally a safe procedure and serious complications are rare. Possible complications are listed below. The list is not exhaustive but contains the most frequent complications:

• Bruises, wound infection and wounds opening up.
• Bleeding of the abdominal wall or navel; this sometimes requires another operation.
• Infection of the prosthesis.
• Accidental injury of the bowel or other abdominal organ.
• Change from keyhole surgery to an open procedure.
• Complications that are not directly caused by the surgery: pneumonia, bladder infection, heart rhythm disorders, etcetera
• Complications associated with general or epidural anaesthesia.
• In the long term, the surgical area will remain painful for some patients.
  
  

Side effects

Some side effects occur very frequently but are no reason for concern:

• Fluid accumulation
  
  After the operation, a swelling often remains for a few weeks where the umbilical hernia was located. This is fluid accumulation (also termed seroma) that usually is not painful but often causes patients concern. This swelling is a normal side effect of the operation. It will slowly disappear of its own accord. If, in exceptional cases, the fluid accumulation causes pain, the surgeon may decide to drain it.

• Bruise
  
  Another common side effect is bruising around the wound. This is no cause for concern either, and it will spontaneously disappear in the weeks following the operation. In case of doubt or concern, feel free to contact your GP or our department.

Repair of a post-pregnancy belly is expected to require hospitalisation for three days. After the surgery, a few drains remain that will be removed based on the instructions of the plastic surgeon. It is important that you are active and move around a lot as soon as possible after the operation. We do recommend you avoid lifting heavy loads and strenuous sport activities for three weeks after the procedure.

You will also be given a bellyband that you may wear in the first weeks for support. After the check-up with the surgeon, three weeks after the operation, you will be able to resume all activities again including lifting and sports.

When you are discharged from the hospital, we will ask you to visit your GP ten days after the procedure to have your wound checked. In case of problems, you or your GP can of course always contact our department.

The Maria Middelares Hernia Centre in Ghent charges the official RIZIV price for an abdominal repair using a prosthesis. The invoice will be sent to you by post after a period of approximately three months. In addition to the surgeon's and anaesthesiologist's fee, this will display the general charges for hospital admission and the use of materials such as the mesh.

As is the case in almost any hospital, there is an additional charge for the use of a single room. At the Maria Middelares General Hospital in Ghent, this additional charge is a maximum of 150% of the official price. No additional charges are added to the fee if a multiple-occupancy room is chosen.

For abdominoplasty by a plastic surgeon, no reimbursement by the RIZIV is available as this falls under aesthetic surgery. A flat rate is charged for this which the patient will be invoiced for through the hospital.

Latest publication date: 14/10/2022