The Italian national consensus conference on the diagnosis and treatment of Rectus Abdominis diastasis in Post-gravidic Women
- 01.12.2025
- Review
Erschienen in:
- Verfasst von
- Umberto Bracale
- Cesare Stabilini
- Giuseppe Cavallaro
- Francesca Pecchini
- Gerardo Sarno
- Ferdinando Agresta
- Michele Carlucci
- Simona Rocchetti
- Alberto Sartori
- Alberto Di Leo
- Jacopo Andreuccetti
- Giusto Pignata
- Ernesto Tartaglia
- Carlo Sagnelli
- Diego Cuccurullo
- Angelo Iossa
- Nereo Vettoretto
- Ruggiero Lionetti
- Camillo Bertoglio
- Marco Confalonieri
- Mario Testini
- Giorgio Soliani
- Christian Galatioto
- Antonio Crucitti
- Micaela Piccoli
- Giampaolo Formisano
- Biancamaria Iacone
- Alberto Aiolfi
- Giuseppa Procida
- Giulia Montori
- Salvatore Tramontano
- Andrea Balla
- Sara Capoccia Giovannini
- Marta Cavalli
- Giampiero Campanelli
- Mauro Podda
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Purpose
Rectus Abdominis diastasis (RAD) is a prevalent condition, particularly in post-gravidic women, with functional and esthetic impact. This Delphi consensus, led by general surgeons, aimed to establish evidence-based recommendations for the diagnosis and management of RAD in post-gravidic women.
Methods
A Delphi process was conducted under the auspices of the Italian Society of Hernia and Abdominal Wall Surgery (ISHAWS), the national chapter of the European Hernia Society (EHS). A steering committee supervised systematic literature reviews to evaluate the quality of evidence and formulate recommendations. Iterative rounds of voting involving 105 expert panellists were conducted, with Consensus defined as ≥ 70% agreement. Non-consensual recommendations were revised and discussed in a plenary session during the Italian Society of Surgery (SIC) Congress, 2024.
Results
Consensus was achieved on 12 recommendations covering RAD diagnosis, classification, and treatment. Key findings included the endorsement of radiological methods for accurate RAD assessment, the establishment of surgical thresholds (> 2.5 cm inter-recti distance for symptom improvement), and the recommendation of minimally invasive linea alba plication for surgical management. Non-operative treatments, such as targeted exercise programs, were emphasized as first-line approaches. For RAD with concomitant hernias of the linea alba with defects > 1 cm, mesh reinforcement was strongly recommended, with extraperitoneal placement preferred. The importance of tailoring approaches based on patient-specific factors and fostering shared decision-making was highlighted.
Conclusion
This consensus provides a structured framework for RAD management, emphasizing accurate diagnosis, tailored treatments, and patient-centered care. Future multicenter studies are required to address remaining evidence gaps and refine these recommendations.
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- Titel
- The Italian national consensus conference on the diagnosis and treatment of Rectus Abdominis diastasis in Post-gravidic Women
- Verfasst von
-
Umberto Bracale
Cesare Stabilini
Giuseppe Cavallaro
Francesca Pecchini
Gerardo Sarno
Ferdinando Agresta
Michele Carlucci
Simona Rocchetti
Alberto Sartori
Alberto Di Leo
Jacopo Andreuccetti
Giusto Pignata
Ernesto Tartaglia
Carlo Sagnelli
Diego Cuccurullo
Angelo Iossa
Nereo Vettoretto
Ruggiero Lionetti
Camillo Bertoglio
Marco Confalonieri
Mario Testini
Giorgio Soliani
Christian Galatioto
Antonio Crucitti
Micaela Piccoli
Giampaolo Formisano
Biancamaria Iacone
Alberto Aiolfi
Giuseppa Procida
Giulia Montori
Salvatore Tramontano
Andrea Balla
Sara Capoccia Giovannini
Marta Cavalli
Giampiero Campanelli
Mauro Podda
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-025-03403-x
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