The Totally Extraperitoneal Repair [TEP]

Diastasis recti is a functional problem of the abdominal wall, sometimes aggravated by association with midline hernias. It is feasible to repair with a posterior approach that allows us to place the meshes in a retromuscular position that is considered ideal. The classic extended fully extraperitoneal approach e-TEP and its variant with suprapubic ascending approach e-TEPSA allow us to achieve this objective in cases of recurrence of surgeries in the subcutaneous space, or when for some reason, it is not desirable to leave a subcutaneous mesh. The retromuscular space allows the use of large prostheses, without the need for fixation, of greater density and in many cases without the need for the use of drainage systems. The use of the extraperitoneal approach is clearly an option to have in the toolbox for the treatment of diastasis recti with or without median line hernia.