Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Mar 16, 2025; 17(3): 104966
Published online Mar 16, 2025. doi: 10.4253/wjge.v17.i3.104966
Three-dimensional reconstruction under computed tomography and myopectineal orifice measurement under laparoscopy for quality control of inguinal hernia treatment
Lei Zhang, Jing Chen, Yu-Ying Zhang, Lei Liu, Han-Dan Wang, Ya-Fei Zhang, Jun Sheng, Qiu-Shi Hu, Ming-Liang Liu, Yi-Lin Yuan
Lei Zhang, Yu-Ying Zhang, Lei Liu, Qiu-Shi Hu, Yi-Lin Yuan, Hernia Center of the Department of General Surgery, The First Affiliated Hospital of Anhui University of Science and Technology, Huainan 232007, Anhui Province, China
Jing Chen, Han-Dan Wang, Ya-Fei Zhang, School of Electrical and Information Engineering, Anhui University of Science and Technology, Huainan 232001, Anhui Province, China
Jun Sheng, Ming-Liang Liu, Imaging Center, The First Affiliated Hospital of Anhui University of Science and Technology, Huainan 232007, Anhui Province, China
Co-first authors: Lei Zhang and Jing Chen.
Author contributions: Zhang L and Chen J designed the article, they contributed equally as co-first authors; Zhang YY and Liu ML collected the data and wrote the paper; Wang HD and Zhang YF were responsible for the three-dimensional reconstruction and data measurement; Liu ML and Sheng J collected the imaging data; Hu QS and Yuan YL modified the content of the manuscript; Zhang L, Chen J, Zhang YY, Liu L, Wang DH, Zhang FY, Sheng J, Hu QS, Liu ML, and Yuan YL have read and approved the version to be submitted.
Supported by the 2022 Provincial Quality Engineering Project for Higher Education Institutions, No. 2022sx031; and the 2023 Provincial Quality Engineering Project for Higher Education Institutions, No. 2023jyxm1071.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of the First Affiliated Hospital of Anhui University of Science and Technology (Approval No. 2022-KY-416-001).
Informed consent statement: This research is retrospective, and the requirement for informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author. Participants gave informed consent for data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lei Zhang, Chief Physician, Professor, Hernia Center of the Department of General Surgery, The First Affiliated Hospital of Anhui University of Science and Technology, No. 203 Huaibin Road, Tianjia’an District, Huainan 232007, Anhui Province, China. 897736085@qq.com
Received: January 11, 2025
Revised: February 6, 2025
Accepted: February 25, 2025
Published online: March 16, 2025
Processing time: 63 Days and 3.5 Hours
Abstract
BACKGROUND

Inguinal hernias are common after surgery. Tension-free repair is widely accepted as the main method for managing inguinal hernias. Adequate exposure, coverage, and repair of the myopectineal orifice (MPO) are necessary. However, due to differences in race and sex, people’s body shapes vary. According to European guidelines, the patch should measure 10 cm × 15 cm. If any part of the MPO is dissected, injury to the nerves, vascular network, or organs may occur during surgery, thereby leading to inguinal discomfort, pain, and seroma formation after surgery. Therefore, accurate localization and measurement of the boundary of the MPO are crucial for selecting the optimal patch for inguinal hernia repair.

AIM

To compare the size of the MPO measured on three-dimensional multislice spiral computed tomography (CT) with that measured via laparoscopy and explore the relevant factors influencing the size of the MPO.

METHODS

Clinical data from 74 patients who underwent laparoscopic tension-free inguinal hernia repair at the General Surgery Department of the First Affiliated Hospital of Anhui University of Science and Technology between September 2022 and July 2024 were collected and analyzed retrospectively. Transabdominal preperitoneal was performed. Sixty-four males and 10 females, with an average age of 58.30 ± 12.32 years, were included. The clinical data of the patients were collected. The boundary of the MPO was measured on three-dimensional CT images before surgery and then again during transabdominal preperitoneal. All the preoperative and intraoperative data were analyzed via paired t-tests. A t-test was used for comparisons of age, body mass index, and sex between the groups. In the comparative analysis, a P value less than 0.05 indicated a significant difference.

RESULTS

The boundaries of the MPO on 3-dimensional CT images measured 7.05 ± 0.47 cm and 6.27 ± 0.61 cm, and the area of the MPO was 19.54 ± 3.33 cm2. The boundaries of the MPO during surgery were 7.18 ± 0.51 cm and 6.17 ± 0.40 cm. The errors were not statistically significant. However, the intraoperative BD (the width of the MPO, P = 0.024, P < 0.05) and preoperative AC (the length of the MPO, P = 0.045, P < 0.05) significantly differed according to sex. The AC and BD measurements before and during surgery were not significantly different according to age, body mass index, hernia side or hernia type (P > 0.05).

CONCLUSION

The application of this technology can aid in determining the most appropriate dissection range and patch size.

Keywords: Hernia; Inguinal; Myopectineal orifice; Three-dimensional reconstruction; Computed tomography; Inguinal hernia

Core Tip: Computed tomography 3-dimensional (CT 3D) reconstruction techniques are combined with laparoscopic measurements to obtain myospubic foramen (MPO) size data. To study the effects of different gender, age, body mass index and other factors on the size of the musopubic foramen. Through the analysis of CT 3D imaging and laparoscopic measurement results, the value of CT 3D reconstruction technology in guiding surgery was clarified. Through a retrospective analysis of 74 patients undergoing laparoscopic tension-free inguinal hernia repair, it was found that the combination of CT 3D reconstruction technology and laparoscopic measurement could effectively obtain relevant data of myospubic foramen to reduce postoperative recurrence and adverse reactions.