Evidence map›Paper›PMID 41484463›Full record

ArticleCommunications medicine2026

Clinical application of HEDI for biomechanical evaluation and visualisation in incisional hernia repair.

Philipp D Lösel, Jacob J Relle, Samuel Voß, Ramesch Raschidi, Regine Nessel, Johannes Görich, Mark O Wielpütz, Thorsten Löffler, Vincent Heuveline, Friedrich Kallinowski

Abstract read
In one paragraph

Article in Communications medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Philipp D Lösel *Department of Materials Physics, Research School of Physics, The Australian National University, Acton, ACT, Australia. philipp.david.loesel@gmail.com.ORCID http://orcid.org/0000-0003-0506-1171
Jacob J Relle *Engineering Mathematics and Computing Lab (EMCL), Interdisciplinary Center for Scientific Computing (IWR), Heidelberg University, Heidelberg, Germany.ORCID http://orcid.org/0009-0007-9275-7922
Samuel VoßForschungscampus STIMULATE, Department of Fluid Dynamics and Technical Flows, Otto von Guericke University Magdeburg, Magdeburg, Germany.ORCID http://orcid.org/0000-0002-9757-7564
Ramesch RaschidiDepartement Chirurgie, Kantonsspital Graubünden, Walenstadt, Switzerland.
Regine NesselGeneral and Visceral Surgery, Municipal Hospital Pirmasens, Pirmasens, Germany.
Johannes GörichRadiological Center, Eberbach, Germany.ORCID http://orcid.org/0009-0000-9882-8305
Mark O WielpützDiagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany.ORCID http://orcid.org/0000-0001-6962-037X
Thorsten LöfflerGeneral and Visceral Surgery, GRN Hospital, Eberbach, Germany.
Vincent HeuvelineEngineering Mathematics and Computing Lab (EMCL), Interdisciplinary Center for Scientific Computing (IWR), Heidelberg University, Heidelberg, Germany.ORCID http://orcid.org/0000-0002-2217-7558
Friedrich KallinowskiGeneral, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.ORCID http://orcid.org/0000-0003-4657-9938

Funding

Department of Education and Training | Australian Research Council (ARC) IC 180100008
6 · The paper itself

Abstract

backgroundAbdominal wall defects, such as incisional hernias, are a common source of pain and discomfort and often require repeated surgical interventions. Traditional mesh repair techniques typically rely on fixed overlap based on defect size, without considering important biomechanical factors like muscle activity, internal pressure, and tissue elasticity. This study aims to introduce a biomechanical approach to incisional hernia repair that accounts for abdominal wall instability and to evaluate a visualisation tool designed to support surgical planning.

methodsWe developed HEDI, a tool that uses computed tomography with Valsalva manoeuvre to automatically assess hernia size, volume, and abdominal wall instability. This tool was applied in the preoperative evaluation of 31 patients undergoing incisional hernia repair. Surgeries were performed concurrently with the development of the tool, and patient outcomes were monitored over a three-year period.

resultsHere we show that all 31 patients remain free of pain and hernia recurrence three years after surgery. The tool provides valuable visual insights into abdominal wall dynamics, supporting surgical decision-making. However, it should be used as an adjunct rather than a standalone guide.

conclusionsThis study presents a biomechanical strategy for hernia repair and introduces a visualisation tool that enhances preoperative assessment. While early results are promising, the tool's evolving nature and its role as a visual aid should be considered when interpreting outcomes. Further research is needed to validate its broader clinical utility.

Identifiers

PMID41484463
PMCPMC12864906

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.