ArticleSurgical endoscopy2026
To close or not to close: morphologic changes associated with closure of the posterior rectus sheath after posterior component separation.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
Who cites it
2 citing papers in PubMed.
- Technique and outcomes of posterior layer supplementation in retromuscular ventral hernia repair.Surgical endoscopy · 2026Article
- Effect of posterior rectus sheath closure on outcomes of enhanced total extraperitoneal ventral hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThis study aims to evaluate morphologic changes of the rectus muscles after closure of the posterior rectus sheath (PRS) following component separation. There is no consensus on whether to close the PRS, and limited data exists on how closure affects the morphology and potential function of the abdominal wall musculature.
methodsRetrospective review of all patients between 1/1/2016 and 12/31/2022 who underwent PRS release for ventral hernia repair performed by a single surgeon. During this period, some patients had reconstitution of the PRS while others had the posterior layer buttressed with peritoneum. Subjects were included if preoperative and postoperative cross-sectional imaging was available for review and excluded with: transversus abdominis muscle release, external oblique muscle release, open surgery, or complication of hematoma or seroma. Measurements of rectus muscle width and distance between semilunar lines were obtained at the level of the umbilicus, upper, middle, and lower abdomen. Statistical analysis performed using Student's t-test analysis on continuous variables. Significance defined as p = .050.
resultsResults include 90 patients divided into two arms: PRS buttressed versus PRS closed. Closed PRS was associated with significantly decreased percent difference in distance between semilunar lines in the middle (4% vs -5%, p = .001), umbilical (2% vs -4%, p = .031), and lower abdomen (2% vs -3%, p = .018) and rectus muscle width in the middle (Right: 20% vs 11%, p = .009; Left: 20% vs 6%, p ≤ .001), umbilical (Right: 20% vs 9%, p = .001; Left: 21% vs 10%, p = .002), and lower abdomen (Right: 8% vs 0%, p = .006; Left: 8% vs -1%, p = .006).
conclusionsRelease and decoupling of PRS results in increased width of rectus abdominis muscle in both cohorts although significantly larger change observed in PRS bridged. Reloading of the PRS brings the semilunar lines closer together as compared to preop measurements, the opposite is observed when leaving the PRS bridged with peritoneum.
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Registered trials
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.