Evidence map›Paper›PMID 41085743›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2025

Surgical treatment of rectus abdominis diastasis with concomitant abdominal wall hernias-perioperative outcomes of 11,658 cases from the Herniamed Registry.

F Köckerling, W Reinpold, H Niebuhr, R Schwab, K Zarras, A Kuthe, J Conze, H Riediger, B Stechemesser, R Lorenz and 2 more

Abstract read
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In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Rectus diastasis is not a single entity: phenotype-specific controversies in surgical management.Hernia : the journal of hernias and abdominal wall surgery · 2026
    Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

F KöckerlingHernia Center, Vivantes Humboldt Hospital, Academic Teaching Hospital of Charité, University Medicine, Am Nordgraben 2, 13509, Berlin, Germany. Ferdinand.koeckerling@vivantes.de.
W ReinpoldHelios Mariahilf Hosptal, Stader Str. 203C, 21075, Hamburg, Germany.
H NiebuhrHansechirurgie, Niebuhr, Marleschki and Partner, Alte Holstenstr. 16, 21031, Hamburg, Germany.
R SchwabDepartment of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital Koblenz, Rübenacher Str. 170, 56072, Koblenz, Germany.
K ZarrasMarien Hospital Düsseldorf, Rochusstrasse 2, 40479, Düsseldorf, Germany.
A KutheDepartment of General and Visceral Surgery, DRK-Krankenhaus Clementinenhaus, Lützerodestr. 1, 30161, Hannover, Germany.
J ConzeUM Hernia Center, Arabellastr. 17, 81925, Munich, Germany.
H RiedigerHernia Center, Vivantes Humboldt Hospital, Academic Teaching Hospital of Charité, University Medicine, Am Nordgraben 2, 13509, Berlin, Germany.
B StechemesserHernia Center, Pan Hospital, Zeppelinstrasse 1, 50667, Cologne, Germany.
R Lorenz3+Chirurgen, Klosterstrasse 34/35 Spandau, 13581, Berlin, Germany.
H HoffmannZwei Chirurgen GmbHCenter for Hernia Surgery and Proctology, St. Johanns‑Vorstadt 44, 4056, Basel, Switzerland.
R FortelnyMedical Faculty, Sigmund Freud University Vienna, Schnirchgasse 9a, 1030, Vienna, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDue to the paucity of data, the only recommendation that can be given in the European Hernia Society guidelines is that, to characterize the patient cohort with rectus abdominis diastasis (RAD), a recognized classification system be used and that defects > 1 cm be repaired with a mesh technique. Otherwise, further studies are needed.

methodsAs from February 2022, it has been possible in the Herniamed Registry to also record patients with rectus abdominis diastasis (RAD) and concomitant ventral hernias separately from those with midline hernias without RAD. The classification system employed by the German Hernia Society was used to that effect. The patient- and procedure-related characteristics were recorded and the perioperative outcomes determined.

resultsBetween February 2022 and January 2025, 11,658 patients with RAD and concomitant ventral hernias were recorded in the Herniamed Registry. Of these patients, 31.3% were women and 68.7% men. In 94.9% of cases, the surgical indication was based on RAD with concomitant ventral hernias. The most frequently used surgical techniques were mini-less-open and endoscopic sublay techniques at 48.9%, open techniques at 30.7% and laparoscopic techniques at 11.0%. The postoperative complication rate was 5.0% and the complication-related reoperation rate 2.3%.

conclusionThe actual situation with regard to repair of RAD with concomitant ventral hernias shows that the preferred surgical techniques are open and mini-less-open as well as endoscopic sublay. The perioperative outcomes with 5% postoperative complications and 2.3% reoperations demonstrate that the techniques are demanding.

Indexed as

Diastasis, MuscleHernia, VentralHerniorrhaphyRectus AbdominisAdultAgedFemaleHumansLaparoscopyMaleMiddle AgedPostoperative ComplicationsRegistriesSurgical MeshTreatment OutcomeAbdominoplastyConcommitant herniaIncisional herniaPerioperative outcomeRectus abdominis diastasisVentral hernia

Identifiers

PMID41085743

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.