Robotic Aesthetic Rectus Diastasis Repair: The Minimally Invasive Robotic Endoscopic Lipoabdominoplasty (MIRELA) Technique

Abstract Background Rectus diastasis is a prevalent condition associated with functional impairment and aesthetic deformity. Although minimally invasive techniques have emerged, they remain limited by technical constraints and incomplete integration with body contouring procedures. Objectives To report our clinical experience with the Minimally Invasive Robotic Endoscopic Lipoabdominoplasty (MIRELA) technique for rectus diastasis repair and abdominal contouring. Methods A retrospective descriptive study was conducted including 55 female patients who underwent MIRELA between 2023 and 2025. After loss to follow-up, 53 patients were included in the final analysis. The procedure combined VASER®-assisted liposculpture with robotic-assisted extraperitoneal rectus plication using the da Vinci Xi® system. Demographic characteristics, perioperative variables, postoperative complications, reinterventions, and hospital readmissions were evaluated. Continuous variables were reported as mean ± standard deviation, and categorical variables as frequencies and percentages. Results The mean age was 39.4 ± 5.1 years, and the mean follow-up was 6 months, ranging from 4 to 9 months. Mean BMI was 21.9 ± 3.4 kg/m2; among patients with available BMI category data, 89.8% were classified within the normal weight range. Mean rectus diastasis width was 3.22 ± 0.95 cm, with 66.0% of patients presenting a diastasis ≥3 cm. Concomitant umbilical hernia was present in 75.5% of cases. All procedures were completed under general anesthesia, with a mean operative time of 190.0 ± 6.1 minutes. No intraoperative or postoperative complications, reinterventions, or hospital readmissions were observed. Conclusions MIRELA is a feasible and reproducible technique that integrates robotic-assisted precision with minimally invasive aesthetic surgery principles. It represents a promising option for a very selected group of patients with minimal-to-moderate rectus diastasis and no excess skin requiring cutaneous excision. Further studies with longer follow-up are required.