"Ideal" navel in abdominoplasty

Introduction. According to the scientific literature, umbilical ring hernias in the structure of operated hernias of the anterior abdominal wall range from 4% to 7%, and their combination with diastasis of the rectus abdominis muscles reaches 60%. Divergence (diastasis) of the rectus abdominis muscles occurs mainly in women who have given birth more than once, etiologically it is caused by muscular dystopia and weakness of aponeurotic elements. The choice of umbilicoplasty largely determines the condition of postoperative scars and the aesthetic result of the operation.The purpose of the study. Taking into account the anatomical and functional features of the anterior abdominal wall, to improve the results of abdominoplasty performed in patients with abdominal muscle diastasis complicated by umbilical hernias.Materials and methods. The study included women of the second adult and mature age. By physique, there were 50% exomorphs, 41,7% mesomorphs and 60% endomorphs. All women underwent dermolipectomy, hernioplasty according to K.M. Sapezhko, suturing of the diastasis of the rectus abdominis muscles. 31 women underwent surgery according to the author's method (RF patent 2749475 dated 11.06.21), in 34 - suturing of the distasis and the formation of the non-navel was performed according to the standard method.Results. In 34 women who had diastasis suturing and dermolipectomy performed by the traditional method in the postoperative period, marginal navel necrosis was diagnosed in two cases, one patient had navel necrosis of 60% and one patient was diagnosed with 100% navel lesion. Navel necrosis was not observed in the study group. In addition, pain syndrome was less pronounced in the postoperative period in women operated by the author's method, and aesthetic satisfaction with appearance was significantly higher than in women of the control group.Conclusion. The proposed method of umbilicoplasty with suturing of the diastasis of the rectus abdominis muscles avoids navel necrosis and improves the aesthetic satisfaction of patients with the appearance of the anterior abdominal wall.