Functional 3DVR imaging of abdominal wall hernias.

The purpose of this illustrative pictorial series is to demonstrate the value of an image technique known as 3D Volume Rendering (3DVR) for the pre-operative visualization and assessment of complex abdominal hernias. A small subset of complex abdominal hernia cases were selected from our early clinical experience with 3DVR to illustrate the value of visualizing standard 2D computed tomography (CT) data from a 3D perspective. For the surgeon, pre-operative 3DVR can assist the holistic understanding of abdominal hernias and any associated fascial defects, unsuspected additional hernias, dysfunctional abdominal wall bulges/eventrations, muscle denervations or atrophic changes, mesh placements, other post-surgical changes such as scarring, and relevant skeletal changes. For the patient, 3DVR provides an easily grasped understanding of the relevant anatomy, the nature of the problem at hand, and the scale of the surgical challenge. Images of this kind can help the surgeon to more effectively manage unrealistic patient expectations or explain dysfunctional bulges that do not require surgery. A functional 3DVR approach to pre-operative imaging can provide the surgeon with a more complete understanding of any hernia defect and the relevant background status of the abdominal wall in general. This can be useful in planning a more effective operative approach and help to improve surgical outcomes.