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3D tomographic reconstruction in complex ventral hernias. Does it make a difference? Subjective evaluation of
Bruno de Lima Rodrigues1,2, Marcelo Gonçalves de Oliveira3, Diego Paim Carvalho Garcia4
1Faculdade de Ciências Médicas de Minas Gerais - FCMMG, Faculdade de Medicina, FELUMA - Lucas Machado Educational Foundation, Belo Horizonte, Minas Gerais, Brazil. bruno.rodrigues@cienciasmedicasmg.edu.br.
Hernia : the Journal of Hernias and Abdominal Wall Surgery
|August 29, 2025
Summary
Three-dimensional (3D) CT reconstructions do not significantly improve surgical planning for ventral hernias compared to conventional 2D CT. Standard 2D CT remains sufficient for surgical decision-making in these complex cases.
Area of Science:
- Radiology
- Surgical Planning
- Medical Imaging
Background:
- Ventral hernias present surgical challenges requiring detailed preoperative assessment.
- Computed tomography (CT) is standard for preoperative evaluation.
- Three-dimensional (3D) CT reconstructions are increasingly used in surgery.
Purpose of the Study:
- To evaluate if 3D CT reconstructions enhance surgical planning for ventral hernias compared to conventional 2D CT.
- To compare surgeon's perception and decision-making using 2D vs. 3D CT.
- To determine the clinical utility of 3D CT in complex ventral hernia repair.
Main Methods:
- A cross-sectional survey of 66 surgeons was conducted.
- Surgeons were randomized to assess ventral hernias using 2D CT or both 2D and 3D CT.
- Data collected via questionnaires on hernia characteristics, planning, and treatment strategies; analyzed using Fisher's exact test, Chi-square, and ROC analysis.
Main Results:
- No significant differences in hernia evaluation, preoperative planning, or surgical approach between 2D and 3D CT groups.
- 3D reconstructions reduced perceived omental content (74.2% vs. 97.1%, p=0.01).
- 3D visualization did not alter surgical decisions (mesh selection, component separation, loss of domain management).
Conclusions:
- 3D CT reconstructions do not offer significant advantages over 2D CT for evaluating or planning complex ventral hernia repairs.
- While 3D imaging may improve visualization, its clinical impact on surgical decisions is not established.
- Conventional 2D CT, with careful analysis, is adequate for surgical decision-making in ventral hernia cases.
