[The innovative FRANCIS method-A case report : Combination of abdominoplasty and sublay repair with preservation of the umbilicus in postpartum rectus diastasis and umbilical hernia].

INTRODUCTION

Postpartum rectus diastasis and abdominal wall insufficiency frequently cause functional and aesthetic complaints, including impaired core stability, pain, postural disorders and psychosocial burden. Concomitant umbilical hernias often require surgical treatment. Although current guidelines recommend minimally invasive procedures with mesh reinforcement, many patients remain dissatisfied with the cosmetic outcome. Therefore, treatment requires a combination of functional reconstruction and aesthetic restoration. Preservation of the umbilical viability represents a particular surgical challenge. For this purpose, the FRANCIS technique (females postpartum with rectus diastasis benefit from abdominoplasty in navel-sparing technique combined with intervention in sublay technique) was developed, combining a navel-sparing abdominoplasty with a retromuscular sublay reconstruction.

MATERIAL AND

METHODS

This report demonstrates the technique using an illustrative patient case. Developed at Franziskus Hospital Vienna, the procedure combines functional abdominal wall reconstruction with aesthetic optimization. Due to the specific vascular supply of the umbilicus, a precise intraoperative strategy is required to prevent ischemia or necrosis. The report describes the surgical procedure and the anatomical considerations necessary for the safe combination of both techniques.

RESULTS

The combination of retromuscular sublay repair and abdominoplasty proved to be safe and feasable. Restoration of abdominal wall integrity and contour was achieved while preserving umbilical viability. No perfusion-related complications occurred. The findings suggest potential improvements in postoperative quality of life.

CONCLUSION

The FRANCIS technique combines functional reconstruction and aesthetic objectives while respecting the vascular anatomy of the umbilicus and represents a promising approach for postpartum patients with umbilical hernia and rectus diastasis.