الفهرس 
Review of literatureOnly 14 pages are availabe for public view
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Abstract
According to the American Society of Plastic Surgeons, abdominoplasty is the fifth most common cosmetic surgery in the United States. Patients often seek abdominal wall contouring procedures to address issues such as excess skin and fat after pregnancy, significant weight loss, and uneven distribution of fat. These concerns can result in difficulties with activities like exercise, sexual activities, finding well-fitting clothing, and maintaining good hygiene.
ARD a separation of the rectus abdominis muscles, is a common postpartum concern affecting abdominal aesthetics and function. Abdominoplasty with plication aims to correct this separation and restore structural integrity Traditionally, surgeons relied solely on intraoperative assessment to determine the appropriate plication amount.
However, excessive plication could be complicated by abdominal compartment syndrome or respiratory distress. Moreover, in mild cases, it is considered unphysiological and can be associated only with unexplained pain and a longer recovery time.
Regarding, abdominal compartment syndrome (ACS), It is a serious complication that happens when the abdomen is subjected to increasing pressure beyond the point of intra-abdominal pressure i.e., 20 mmHg. It can be a fatal problem that results in multi-organ dysfunction.
Moreover, Respiratory failure, secondary to an abrupt increase in Intra-abdominal pressure (IAP) results from a sudden diaphragmatic elevation that causes loss of static and dynamic pulmonary compliance. It is characterized by high ventilatory pressures, hypoxia, and hypercarbia.
The main factor for accurate estimation of the amount of musculoaponeurotic plication is the surgeon’s experience.
The computed tomography (CT) scan is a known modality for estimating the ratio between hernia volume and peritoneal volume. This can predict, preoperatively, whether the contents could be reduced safely with a tension-free fascial closure without use of extra manoeuvres or not.
Complications following rectus diastasis repair are infrequent and include infection, mesh extrusion, recurrence, nerve injury, seroma, complex scar, skin necrosis, contour abnormality, and visceral injury.
Our study aimed to address the role of CT as a preoperative tool to estimate the plication needed for recti diastasis by comparing the gap between CT-calculated plication with intraoperative plication measurements with an evaluation effect of plication on IAP and PAP.
Study limitations
The study was conducted on a relatively small sample size of females within a specific age range (34 - 49 years) and BMI (26.4 - 29.8).
Conclusion
The findings of this study suggest that CT-calculated plication can be a useful tool for preoperative planning, but it should not be used as the sole determinant of intraoperative plication. The surgeon’s experience and clinical assessment during surgery remain crucial, especially in cases where CT-based estimations deviate significantly from the intraoperative findings.
The reliability of the pre-operative estimated plication with Abdominal CT “ARD measures” was less than intraoperative plication done by surgeons without harmful effects on IAP and PAP.
Recommendation
Recommendations for further studies are needed to evaluate if surgeons do Plication for recti muscle more than diastasis generally in abdominoplasty or if Ct measurement is not reliable in estimated plication (a measure of diastasis) needed with large sample size, including a wide range of ages, wide BMI range and men too, are necessary for identifying the real prevalence.