An Abdominoplasty Modification for Postpregnancy Abdomen with Rectus Diastasis and Midline Hernia: The Technique and Results
Bibliographic record
Abstract
SUMMARY: After pregnancy, some women experience severe rectus diastasis (RD), with body control dysfunction, midline hernia, or other quality-of-life impairment. The purpose of this study was to describe the authors' experience using hydrodissection and epidural anesthesia for lateral plication modification of abdominoplasty to restore abdominal wall firmness. A total of 46 consecutive patients with RD after pregnancy were enrolled. The mean intraoperative inter-rectus distance was 4.6 cm. RD is not always the only structure that has been elongated. Firmness of the abdominal wall also depends on lateral fascia structures. This study reports the total plicated distance addressing the lateral laxity in the abdominal wall. In this series, total plication was 7.8 cm, and 16 patients had a midline hernia. No hernia recurrences occurred, and the rectus bellies were less than 5 mm apart from each other in all participants, verified with ultrasound after 2 years of follow-up. Patient perspective of care and surgical outcome were recorded. Health-related quality-of-life domains were significantly improved postoperatively. Lumbar back pain visual analogue scale score was 4.5 ± 2.3 preoperatively and 0.5 ± 0.9 postoperatively. The ability to perform sit-ups increased from zero to 11, suggesting better motor control. The total complication rate was 10.9%. Hydrodissection and epidural anesthesia for lateral plication modification offers a reliable and effective treatment method for RD repair with and without a small midline hernia with a low complication rate. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".