What Is Rectus Diastasis?
Rectus diastasis, also called diastasis recti or abdominal separation, occurs when the two parallel bands of the rectus abdominis — the “six-pack” muscles — pull apart along the midline of the abdomen. The connective tissue between them, known as the linea alba, stretches and thins, leaving a gap that allows the abdominal contents to bulge forward, particularly when sitting up or straining.
The condition is most common after pregnancy and significant weight change, but it also affects men. While rectus diastasis is not itself a hernia, it weakens the abdominal wall and frequently occurs alongside umbilical or ventral hernias. Dr. Pakula evaluates each patient individually and, when surgery is appropriate, repairs the separation using robotic technology that reapproximates the muscles through small incisions — often addressing any coexisting hernia at the same time.
What Causes Rectus Diastasis
Rectus diastasis develops when sustained pressure or stretching forces the abdominal muscles apart faster than the connective tissue can adapt. Several factors increase the likelihood and severity of separation.
Signs & Symptoms
Rectus diastasis can be subtle or pronounced. Many patients notice a change in the shape of the abdomen that does not respond to diet or exercise. Common signs include the following.
Diagnosis & Evaluation
Rectus diastasis is usually diagnosed during a physical examination, when Dr. Pakula measures the width of the gap between the muscles while the abdomen is relaxed and engaged. Because diastasis so often coexists with a hernia, imaging such as ultrasound or CT may be ordered to map the abdominal wall accurately and confirm whether a hernia is also present.
A thorough evaluation matters: it distinguishes a true muscle separation from a hernia, defines the size of the defect, and guides whether conservative management or surgical repair is the right path. Dr. Pakula reviews your history, symptoms, and goals before recommending any procedure.
When Surgery Is Considered
Mild diastasis — particularly in the months following pregnancy — often improves with targeted physical therapy and core rehabilitation, and surgery is not always necessary. Repair is considered when the separation is wide or persistent, when it causes functional weakness, back pain, or discomfort, or when a hernia is present alongside it.
Surgical repair restores the normal anatomy by bringing the rectus muscles back to the midline and reinforcing the abdominal wall. For patients with a coexisting hernia, the two problems are addressed together in a single operation, avoiding the need for separate procedures and recoveries.
Robotic & Minimally Invasive Repair
Dr. Pakula performs rectus diastasis repair using the Da Vinci robotic system, which provides three-dimensional visualization and precise instrument control through a few small incisions. This robotic approach allows her to reapproximate the separated muscles, reinforce the midline, and place mesh when needed — all without the long incision of a traditional open abdominoplasty-style repair.
Compared with open surgery, minimally invasive repair generally means less post-operative pain, smaller scars, a lower risk of wound complications, and a faster return to normal activity. When diastasis and a hernia occur together, Dr. Pakula’s expertise in complex abdominal wall reconstruction allows both to be corrected durably in one minimally invasive operation.