Surgical Anatomy of the Anterolateral Wall of the Abdomen and Classification of the Diastasis Recti

The anatomy of the abdominal wall is complex and elegant. Understanding the fascial planes and vascular, nerve, and lymphatic supply is critical to obtain the best aesthetic results with minimal morbidity. The functions of the abdominal wall cannot be understood without knowing its attachments to the diaphragm and perineum, explaining the stability of the spine and adequate control of the sphincters. The best surgical option is one that restores the anatomy and function of the abdominal wall, that is, one that reconstructs the linea alba. The benefit of functional surgery in DR is explained based on the aponeurotic and fascial muscle complex of the abdominal wall as a single entity or core. Tension on the linea alba and the fascial and muscular integrity of the transversus abdominis muscle are necessary for the maintenance of normal function of the abdominal core. The preperitoneal fascial plane is the only global compartment, without limits under the abdominal wall. As the ideal working plane, we accept the avascular between both oblique muscles. Knowledge of neural and vascular anatomical variants is essential to reduce surgical complications. During dissection of the abdominal wall and preperitoneal space, the surgeon must remember the anastomoses between the epigastric vessels, the retropubic branches of both obturator arteries, the suprapubic branches of the inferior epigastric arteries, and the retropubic and suprapubic branches of the obturator.