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Rectus muscle plication is a surgical procedure that tightens the rectus abdominis muscles, which are the abdominal muscles that run from the sternum down to the pelvis. This procedure is often necessary during tummy tucks as it helps to prevent a pooch appearance in the stomach caused by diastasis recti, the separation of the two segments of the abdominal muscles. Rectus muscle plication is also used to treat strabismus, a common ocular problem, as an alternative to rectus muscle resection. The procedure involves suturing the muscle to the sclera, which strengthens the muscle with less tissue trauma and bleeding than resection.
| Characteristics | Values |
|---|---|
| Definition | Rectus muscle plication is a surgical procedure that tightens the rectus abdominis muscles |
| Alternative Names | Muscle repair, tummy tuck |
| Use Cases | Diastasis recti, strabismus, esotropia, exotropia, abducens nerve palsy |
| Techniques | Adjustable suture, cinch technique, muscle-to-muscle suture fixation, modified rectus tuck |
| Benefits | Less invasive, reversible, lower risk of "lost" muscles, reduced tissue trauma and bleeding, simpler technique, decreased operative time |
| Risks | Inability to address pattern strabismus or small vertical deviations |
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What You'll Learn
- Rectus muscle plication is a less invasive alternative to rectus muscle resection
- It is a muscle-strengthening procedure that can be performed using adjustable sutures
- The procedure can be used to repair diastasis recti, a condition where the abdominal muscles separate
- It is a technically simple surgical procedure with a low risk of complications
- Rectus muscle plication can be performed on any of the four rectus muscles
Rectus muscle plication is a less invasive alternative to rectus muscle resection
Diastasis recti is the term used to describe the separation of the two segments of the abdominal muscle, which can weaken the overall structure of the abdomen and cause a pooch appearance. This condition can be caused by pregnancy, weight gain or loss, and previous abdominal surgeries. To check for diastasis recti, one can lie on their back with bent knees and place their fingertips along the middle of their stomach, slowly applying pressure downward. If you do not have diastasis recti, you will feel hard, toned muscles; if you do, your fingers may sink or feel space.
Rectus muscle plication is a less invasive procedure that does not require muscle disinsertion, reducing the risk of "lost" muscles and anterior segment ischemia. It is also more easily reversible and may impinge less on anterior segment circulation. The technique involves isolating the muscle on a muscle hook and dissecting the connective tissue posteriorly. The desired amount of plication is then measured, and sutures are passed and secured at a distance corresponding to the selected amount of plication. Finally, the sutures are fixated using partial scleral thickness passes.
This procedure has been found to be effective in treating strabismus, a common ocular problem in children and adults, and has been shown to have similar results to rectus muscle resection in treating esotropia and exotropia. The plication technique is also argued to be simpler than resection, potentially resulting in decreased operative time. However, one disadvantage is that plications cannot be used to shift muscles for pattern strabismus or small vertical deviations.
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It is a muscle-strengthening procedure that can be performed using adjustable sutures
Rectus muscle plication is a muscle-strengthening procedure that can be performed using adjustable sutures. It is a surgical technique that tightens the rectus abdominis muscles, which are the abdominal muscles responsible for a "six-pack" and play a role in both cosmetic and medical anatomy. Diastasis recti, or the separation of the two segments of the abdominal muscle, can be addressed through rectus muscle plication during a tummy tuck procedure. This separation can be caused by pregnancy, weight fluctuations, or previous abdominal surgeries, leading to a weaker abdomen and a "pooch" appearance.
The plication procedure can be performed using adjustable sutures, which offer the advantage of postoperative adjustability. The muscle is first isolated on a muscle hook, and the desired amount of plication is measured from the muscle insertion using calipers. Two single-armed 6-0 polyglactin 910 or nonabsorbable polyester sutures are then passed and secured at a distance corresponding to the selected amount of plication. The sutures are fixated using partial scleral thickness passes adjacent to the rectus tendon insertion.
The use of adjustable sutures in rectus muscle plication provides several benefits. Firstly, it is a less invasive technique compared to rectus muscle resection, and it is also more easily reversible. Secondly, it may reduce the risk of anterior segment ischemia and lost" muscles since the muscle is never disinserted from the sclera. Additionally, this technique can preserve anterior ciliary circulation and minimise tissue trauma and bleeding.
One disadvantage of the plication procedure is that it cannot be used to address specific types of strabismus, such as pattern strabismus or small vertical deviations, which require the vertical transposition of the horizontal rectus muscle. However, plication has been found to be effective in treating strabismus in many cases, and it offers a simpler technique and potentially reduced operative time compared to resection.
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The procedure can be used to repair diastasis recti, a condition where the abdominal muscles separate
Diastasis recti is the medical term for the separation of the abdominal muscles. This condition is fairly common, especially in women who have been pregnant, affecting as many as 60% of women following pregnancy. It can also affect men and children. Diastasis recti can be caused by pregnancy, weight gain or loss, and previous abdominal surgeries. While it is usually not dangerous, it can contribute to certain medical and cosmetic issues. For example, it can weaken the overall structure of the abdomen and cause a protruding stomach.
Rectus muscle plication is a surgical procedure that can be used to repair diastasis recti. It is often performed during tummy tuck surgery, also known as abdominoplasty. During the procedure, an incision is made from hip to hip, and the muscles are repaired and tightened. Rectus muscle plication aims to narrow the widened linea alba and return the rectus muscle bellies to their anatomical position.
The procedure is considered less invasive than other surgical techniques and can be performed using adjustable sutures. It may also impinge less on anterior segment circulation and does not require muscle disinsertion, minimising the risk of "lost" muscles. There is some evidence that rectus muscle plication can improve abdominal strength and function, but the existing literature is limited and heterogeneous, making it difficult to draw strong conclusions.
It is important to consult a certified professional for the diagnosis and treatment of diastasis recti. While self-checks can be performed, a professional can provide an accurate diagnosis and determine the most appropriate treatment option, which may include surgical procedures such as rectus muscle plication or non-surgical approaches such as exercise programs.
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It is a technically simple surgical procedure with a low risk of complications
Rectus muscle plication is a technically simple surgical procedure with a low risk of complications. It is a less invasive alternative to rectus muscle resection, which can be performed on any of the four rectus muscles. The procedure involves the use of adjustable sutures to strengthen the muscles without the need for muscle disinsertion, reducing the risk of ""lost" muscles and anterior segment ischemia.
During the procedure, the rectus muscle is isolated on a muscle hook, and connective tissue is dissected posteriorly. The desired amount of plication is measured, and non-absorbable polyester sutures are passed through the muscle at a specific distance from the insertion, corresponding to the selected amount of plication. The sutures are then fixated using partial scleral thickness passes, creating a fold in the tendon that is sutured to the sclera. This adjustable suture technique allows for postoperative adjustments if needed.
The simplicity of the procedure, along with its potential reversibility, makes rectus muscle plication a favourable option for muscle-strengthening. It can be particularly useful in treating conditions such as strabismus and diastasis recti, also known as muscle separation. In the case of diastasis recti, rectus abdominis muscles separate, causing a weakening of the abdomen and a ""pooch" appearance. Rectus muscle plication can help tighten these muscles, improving both cosmetic and medical concerns.
While rectus muscle plication is generally considered safe, it is important for patients to understand the potential risks and side effects. Although rare, there is a chance of anterior segment ischemia, which can occur if the blood supply to the anterior segments is disrupted during surgery. Additionally, as with any surgical procedure, there are inherent risks of infection, bleeding, and adverse reactions to anaesthesia. Therefore, it is crucial for patients to discuss the potential benefits and risks with their healthcare providers before undergoing rectus muscle plication.
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Rectus muscle plication can be performed on any of the four rectus muscles
Rectus muscle plication is a surgical technique that can be performed on any of the four rectus muscles. It is an alternative to rectus muscle resection, involving the tightening of the rectus abdominis muscles. These muscles are responsible for the abdominal six-pack and play a role in both cosmetic and medical anatomy. For example, they help with urination, breathing, and supporting the spine, while also protecting the internal organs.
The procedure can be used to treat diastasis recti, which occurs when the two segments of the abdominal muscle separate, causing a weakness in the abdomen's structure. This condition can result from pregnancy, weight fluctuations, and previous abdominal surgeries. Rectus muscle plication is often performed during tummy tuck surgery to achieve a flat stomach.
The plication technique offers advantages over resection, including a lower risk of "lost" muscles, preservation of anterior ciliary circulation, and reduced tissue trauma and bleeding. It is also less invasive, more easily reversible, and does not require muscle disinsertion, minimising the risk of anterior segment ischemia.
The surgical procedure involves isolating the muscle on a muscle hook and dissecting the connective tissue posteriorly. The desired amount of plication is measured, and sutures are passed and secured at a distance corresponding to the selected amount of plication. The sutures are then fixated using partial scleral thickness passes adjacent to the rectus tendon insertion.
Overall, rectus muscle plication is a strengthening procedure that can be applied to any of the four rectus muscles, offering advantages over resection in terms of invasiveness, reversibility, and reduced risks of complications.
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Frequently asked questions
Rectus muscle plication is a surgical procedure that tightens the rectus abdominis muscles.
The rectus abdominis, also known as abdominal muscles, are responsible for the six-pack of some people. These muscles run from the sternum down to the pelvis.
The abdominal muscles help with urination, breathing, and supporting the spine. They also protect the internal organs.
Pregnancy, weight gain or loss, and previous abdominal surgeries can cause the muscles of the rectus abdominis to separate, leading to diastasis recti. This condition weakens the overall structure of the abdomen and can cause a pooch appearance in the stomach. Rectus muscle plication is often necessary during a tummy tuck to achieve a flat stomach.
Rectus muscle plication is a less invasive, more easily reversible alternative to rectus muscle resection. It has a lower risk of "lost" muscles and anterior segment ischemia. The procedure is also simpler and can result in decreased operative time.
