SCOLA — Abdominal Diastasis in Uberlândia-MG

Abdominal diastasis is the separation of the rectus abdominis muscles at the midline (linea alba), often associated with hernias of the abdominal wall, such as an umbilical hernia. Surgical indication is generally considered when there are associated symptoms — such as pain, a concurrent hernia, or a relevant functional impact — and the decision is always individualized, made in consultation with the surgeon after clinical evaluation and, when necessary, imaging exams.

SCOLA (Subcutaneous Onlay Laparoscopic Approach) is a minimally invasive technique performed through small incisions, generally in the suprapubic region, allowing access to the plane between the skin and the abdominal muscles for plication (approximation suturing) of the linea alba, correcting the diastasis — without mesh in most cases, since reinforcement is reserved for large associated hernias — without the need for large incisions or skin removal, unlike traditional abdominoplasty.

The surgery is generally performed under general anesthesia, with an individualized preoperative anesthesia evaluation to check the patient's clinical condition. In some cases, the anesthesia team may add abdominal wall blocks as part of the pain management strategy, but this decision is always technical and made case by case.

Duration varies according to the extent of the diastasis, the presence of associated hernias, and the complexity of each case, generally taking from about one to a few hours. This is only a general reference and may be longer or shorter depending on the findings during the procedure itself.

The plan is one day in hospital: the patient has the operation, stays overnight and is discharged the following day. This may vary according to clinical progress, any associated procedures and the medical team's assessment, and is confirmed individually, close to the time of discharge.

In the first few days, relative rest is generally recommended, avoiding physical exertion, heavy lifting, and sudden trunk movements. Short walks are usually encouraged early on to reduce the risk of complications related to immobility, but the pace of return to activities should always follow individual medical guidance.

Use of an abdominal compression belt or binder is generally recommended after surgery, aimed at reducing swelling, discomfort, and the space created by subcutaneous dissection. Duration of use varies according to the surgeon's guidance and each patient's progress, and may extend for a few weeks.

Return to work generally happens at around 15 days. This timeframe depends on the nature of the activity, the type of anesthesia and analgesia used and each patient's individual healing progress, and is assessed case by case by the surgeon at follow-up visits: light or office-based activities tend to be resumed before jobs requiring physical effort.

High-impact exercise or activities that involve lifting weight are generally cleared at around 30 days. Resuming physical activity is always gradual, especially for exercises involving the abdominal muscles, and depends on evaluating healing and consolidation of the muscle plication — this timeframe varies between patients and should always be agreed upon with the surgeon, so as not to compromise the outcome of the repair.

Since the technique involves creating a subcutaneous space (separation between skin and muscle), care generally includes watching for signs of fluid buildup in the area, using a compressive dressing, and, when indicated by the team, a temporary drain. Any increase in swelling, redness, discharge, or fever should be reported promptly to the medical team.

Because it involves extensive dissection of the subcutaneous plane, SCOLA is associated, in the surgical literature, with seroma formation (fluid buildup under the skin) as one of the most commonly described complications for this type of approach, in addition to the general risks of any abdominal surgery, such as bleeding, infection, and injury to adjacent structures. The exact frequency of these complications varies between studies and depends on individual factors, and is a point discussed in detail during the preoperative consultation.

As with any abdominal wall repair, there is a possibility of recurrence of the diastasis or an associated hernia, especially in the presence of factors such as large weight fluctuations, future pregnancies, or inappropriate physical exertion after surgery. There is no guarantee of a permanent result, and follow-up with the surgeon helps identify any sign of recurrence early.

Minimally invasive diastasis repair — laparoscopic or robotic, in any technique — is not performed through a health plan: it is always private. What is possible is, when there is a real medical indication that is functional rather than aesthetic, or when there is an associated hernia, to ask the plan to cover part of the hospital stay and of the surgical materials; the surgical team's fees always remain private. Everything is agreed and put in writing before surgery.

This channel is for my private practice. Through the SUS, care does not go through my private practice: the only way to be operated on through the SUS is to go to the health post or Basic Health Unit nearest your home, be assessed by a doctor and, if indicated, be placed in your municipality's regulation queue. The surgeon does not choose the order of who gets operated on through the SUS — the queue is followed strictly, according to SUS rules. I am a Professor of Surgery at the School of Medicine of the Federal University of Uberlândia and I operate on SUS patients at the university hospital, HC-UFU, but it is not possible to schedule your care directly with me through these websites or contacts.

No. With SCOLA the operation is performed by the digestive tract surgeon alone, closing the diastasis through the subcutaneous plane, laparoscopically or robotically. There is no liposuction and no plastic surgery team involved — when localized fat or excess skin also need treating, the conversation moves to the MILA and MAMI techniques.

They are the same as with MILA: only three millimetric keyholes in the lower abdomen, below the bikini line. There is no long incision and no skin removal. The final appearance of any scar varies with individual healing factors.