Incisional Hernia (Scar Hernia): Classification

Classification of incisional hernias

Type Hernia gap extent in fascia level:Hernia gap in cm. Visibility, type of finding, reponibility (restoration to normal position).
I <2 cm Hardly visible when standing or lying down; sonographic (ultrasound) or palpation (palpation) findings.
II <4 cm Visible as a protrusion when standing, flat or spontaneously reducible when lying down
IIb <4 cm Not reducible even by manual reduction
III > 4 cm Visible as a protrusion when standing, flat or spontaneously reducible when lying down
IV > 4 cm Visible in standing and supine position, reduction not spontaneous
IVb > 4 cm Not reducible even by manual reduction
V Total defect of abdominal wall, monstrous prominence in standing and supine position