To investigate the clinical effect of minimally invasive totally extraperitoneal sublay (TES) repair for treatment of diastasis rectus abdominis (DRA) after delivery.

The clinical data of four postpartum DRA patients treated at West China Hospital of Sichuan University from March to July 2022 were analyzed. All patients underwent TES surgery, with a 15 cm×20 cm polypropylene hernia repair mesh placed posterior to the rectus abdominis for reinforcement repair, without the need for staple gun fixation or anti-adhesion mesh. Patients' intraoperative and postoperative recovery conditions were observed. Postoperative follow-up was conducted through outpatient visits, WeChat, and telephone contacts to record patients' recovery and the occurrence of complications.

All four patients successfully completed the TES procedure without conversion to open surgery. Two cases had concurrent umbilical hernias, and one had a linea alba hernia. The average surgery duration was 168 minutes, with a postoperative day 1 numeric pain rating scale average score of 2, and an approximate 2.5 days until drainage tube removal. No postoperative complications occurred, and the average post-hospital stay was 3.5 days. All 4 patients were followed up postoperatively at 1, 3, 6, 9, and 12 months, with no cases of recurrence or complications.

TES is safe, economical and effective in treating DRA after delivery.