Chevrel and Rath [3 (link)] proposed a classification for incisional hernias in 2000. This classification is attractive, because it is simple, and the data required to reach the classification are readily obtained. Three parameters were utilised. Firstly, the localisation of the hernia of the abdominal wall: divided into median (M1–M4) and lateral (L1–L4) hernias. Secondly, the size of the hernia: it was postulated that the width of the hernia defect is the most important parameter (greater than hernia defect surface, length of the hernia or size of the hernia sac), which was divided into four groups (W1–W4). As a third parameter of this classification, subgroups were made for incisional hernias and recurrences: the number of previous hernia repairs was recorded as (R0, R1, R2, R3,…). Although apparently easy to use, this classification has not been commonly used in the literature.
In his book on hernia surgery, “Hernien”, Schumpelick described a classification that divided incisional hernias into five classes [2 ]. The size of the defect, the clinical aspect of the hernia in lying and standing position, the localisation of the incision and the number of previous repairs were used for this classification.
Korenkov et al. [4 (link)] reported on the results of an expert meeting on classification and surgical treatment of incisional hernia, but no detailed classification proposal resulted from this meeting.
Ammaturo and Bassi [6 (link)] suggested an additional parameter to the Chevrel classification. The ratio between the anterior abdominal wall surface and the wall defect surface predicts a strong abdominal wall tension when closing the defect, with possible abdominal compartment syndrome development, and thus might influence the choice of surgical technique.
Recently, Dietz et al. [5 (link)] proposed another alternative classification of incisional hernias in which variables like body type, hernia morphology and risk factors for recurrence were included and recommendations made for surgical repair based on the different types. It is based on a self-explanatory taxonomy and is intended to tailor the repair to the body type and risk factors of the individual patient.
The Swedish Abdominal Wall Hernia Registry presented their data collection sheet for incisional and ventral hernias at the EAES congress in Stockholm in June 2008, which forms the basis for a classification and includes many prognostic relevant variables. For this reason Agneta Montgomery was invited to the consensus meeting to present the method of classification used in Sweden.
In his book on hernia surgery, “Hernien”, Schumpelick described a classification that divided incisional hernias into five classes [2 ]. The size of the defect, the clinical aspect of the hernia in lying and standing position, the localisation of the incision and the number of previous repairs were used for this classification.
Korenkov et al. [4 (link)] reported on the results of an expert meeting on classification and surgical treatment of incisional hernia, but no detailed classification proposal resulted from this meeting.
Ammaturo and Bassi [6 (link)] suggested an additional parameter to the Chevrel classification. The ratio between the anterior abdominal wall surface and the wall defect surface predicts a strong abdominal wall tension when closing the defect, with possible abdominal compartment syndrome development, and thus might influence the choice of surgical technique.
Recently, Dietz et al. [5 (link)] proposed another alternative classification of incisional hernias in which variables like body type, hernia morphology and risk factors for recurrence were included and recommendations made for surgical repair based on the different types. It is based on a self-explanatory taxonomy and is intended to tailor the repair to the body type and risk factors of the individual patient.
The Swedish Abdominal Wall Hernia Registry presented their data collection sheet for incisional and ventral hernias at the EAES congress in Stockholm in June 2008, which forms the basis for a classification and includes many prognostic relevant variables. For this reason Agneta Montgomery was invited to the consensus meeting to present the method of classification used in Sweden.