Results of 1‑year follow‑up after umbilical hernia with rectus abdominis muscle diastasis repair using endoscopic subcutaneous onlay approach (SCOLA).

Introduction: Endoscopic subcutaneous onlay approach (SCOLA) mesh repair in combination with anterior plication of diastasis has recently become a commonly performed procedure.

Aim: The aim of this study was to analyze the results of 1‑year follow‑up in patients after umbilical hernia with rectal abdominal muscle diastasis repair using endoscopic SCOLA.

Materials And Methods: Our prospective cohort study included patients who underwent elective surgery for small‑ (<2 cm) and medium‑ (2-4 cm) size primary umbilical hernia with diastasis recti. The follow‑up period was 12 months. Hernia recurrence and postoperative seroma diagnosis were based on the patient's physical examination and ultrasound assessment. The Carolinas Comfort Scale questionnaire was used to evaluate the quality of life after the surgery.

Result: One hundred patients underwent surgery for umbilical hernia with rectal abdominal muscle diastasis repair. Their mean (SD) age was 39.6 (11.8) years. Most of the patients (n = 77) were women. We found no hernia or diastasis recurrence during 1‑year follow‑up. Seroma was found in 15 patients during the first month of follow‑up. The rate of seroma was 11% after 3 months and 2% after 6 months of follow‑up. Almost all the patients reported mild or moderate symptoms during daily activities after the surgery.

Conclusion: SCOLA is a safe and effective technique for patients with small umbilical hernia with diastasis. It provides an acceptable cosmetic result for carefully selected patients, low postoperative pain, and good quality of life.