Clinical tool

CHECalc Medical Calculator

Objective preoperative planning for abdominal wall reconstruction and large hernias with loss of domain.

Hernia volume and its relationship with the abdominal cavity help guide the surgical strategy.

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Objective planning

A tool for data-driven decisions

CHECalc calculates abdominal cavity and hernia sac volumes from CT diameters, determines the relative hernia volume percentage, and provides an indicative estimate of the air volume for progressive preoperative pneumoperitoneum.

These data support assessment of botulinum toxin infiltration, progressive pneumoperitoneum, and the most appropriate reconstructive technique —Rives, Stoppa or component separation—. They also provide a structured record of the surgeon’s caseload.

CHECalc clinical form

Measurements in centimetres obtained from abdominal CT.

A. Patient data

Age (years) Sex Aponeurotic defect (cm)

B. Hernia sac

Transverse diametercm Longitudinal diametercm Depthcm

C. Abdominal cavity

Transverse diametercm Longitudinal diametercm Depthcm

D. Treatment record

Botulinum toxin preparation Repair technique Commercial mesh

Instructions

How to use CHECalc

Enter the CT measurements in centimetres and select “Calculate results”. You can complete the treatment record and print the form for the patient’s medical notes.

Enter the measurements

Enter the three hernia sac diameters and the three abdominal cavity diameters.

Review the results

Review the volumes in litres, the hernia percentage, and the indicative PPP estimate.

Print the record

Save the clinical report together with the technique, mesh, and preparation used.

Interpretation

Understanding the calculated percentage

< 20%

No loss of domain

The hernia sac has a low volume relationship with the abdominal cavity. Strategy should be individualised according to anatomy and clinical context.

20–40%

Moderate loss of domain

Preoperative preparation with botulinum toxin and/or progressive preoperative pneumoperitoneum may be required.

> 40%

Severe loss of domain

Specialist assessment, full preoperative planning, and individualised complex reconstruction are required.

Advisory tool for healthcare professionals

CHECalc supports surgical planning but does not replace clinical judgement or individual assessment by an abdominal wall specialist. Treatment decisions must follow a complete evaluation of the patient.

Scientific evidence

Recommended medical references

References on CT volumetry, loss of domain, botulinum toxin, and progressive preoperative pneumoperitoneum.

Tanaka EY et al. A computerized tomography scan method for calculating the hernia sac and abdominal cavity volume in complex large incisional hernia with loss of domain. Hernia. 2010;14:63–69.
Goñi-Moreno I. Chronic eventrations and large hernias; preoperative treatment by progressive pneumoperitoneum. Surgery. 1947;22:945–953.
Ibarra Hurtado TR. Toxina botulínica A: su importancia en pacientes con grandes hernias abdominales. Rev Hispanoam Hernia. 2014;2(4):131–132.
Pamiés Guilabert J, Aboud Llopis C, Navarro Aguilar V. La valoración cualitativa y cuantitativa de la hernia abdominal con tomografía computarizada multidetector. Rev Hispanoam Hernia. 2013;1(4):149–158.

Open access: CHECalc is available to the international medical community and is prepared for future multilingual publication in Spanish, English, and French.

Would you like a specialist assessment of these measurements?

Send us your imaging study and we will advise you on the most appropriate strategy for your case.