Background: Ventral hernia is a complex and progressive condition that may lead to serious complications. However, no specified grading or classifying system is found to categorize the hernia, which leads to clinical complexities and may affect the patient outcome. Aim: The general aim of this paper is to build up an easy and comprehensive grading system to categorize ventral hernia. Methodology: By carrying out a secondary search over clinical presentation, physical examination, and imaging studies of ventral hernia, a valid grading system is developed. Results: Hanoon’s grading system is composed of seven grades, grades 1, 2A, 2B, 3A, 3B, 3C, and 4. Each grade entailed different clinical presentations, imaging characteristics, and progressivity of ventral hernia. Conclusion: Hanoon’s grading system for ventral hernia can be used to solve the clinical complexities of ventral hernia. Also, it can be a step forward in hernia research to build upon.
Öberg, S., Andresen, K. and Rosenberg, J. (2017) Etiology of Inguinal Hernias: A Comprehensive Review. Frontiers in Surgery, 4, Article 52. https://doi.org/10.3389/fsurg.2017.00052
Appleby, P.W., Martin, T.A. and Hope, W.W. (2018) Umbilical Hernia Repair: Overview of Approaches and Review of Literature. Surgical Clinics, 98, 561-576. https://doi.org/10.1016/j.suc.2018.02.001
Yang, M.J., Russell, K.W., Yoder, B.A. and Fenton, S.J. (2021) Congenital Diaphragmatic Hernia: A Narrative Review of Controversies in Neonatal Management. Translational Pediatrics, 10, 1432-1447. https://doi.org/10.21037/tp-20-142
Kanters, A.E., Krpata, D.M., Blatnik, J.A., Novitsky, Y.M. and Rosen, M.J. (2012) Modified Hernia Grading Scale to Stratify Surgical Site Occurrence after Open Ventral Hernia Repairs. Journal of the American College of Surgeons, 215, 787-793. https://doi.org/10.1016/j.jamcollsurg.2012.08.012
Franz, M.G. (2008) The Biology of Hernia Formation. Surgical Clinics of North America, 88, 1-15. https://doi.org/10.1016/j.suc.2007.10.007
Mutwali, I.M. (2014) Incisional Hernia: Risk Factors, Incidence, Pathogenesis, Prevention, and Complications. Sudan Medical Monitor, 9, 81. https://doi.org/10.4103/1858-5000.146580
Berger, D. (2016) Evidence-Based Hernia Treatment in Adults. Deutsches Ärzteblatt International, 113, 150-158. https://doi.org/10.3238/arztebl.2016.0150
Hassaan, S., Sena, A.E.R.A. and Omar Al-alfy, M. (2020) Management of Irreducible Hernia Using Polypropylene Mesh. Al-Azhar Medical Journal, 49, 1123-1134. https://doi.org/10.21608/amj.2020.91633
Reinke, C.E. and Matthews, B.D. (2020) What’s New in the Management of Incarcerated Hernia. Journal of Gastrointestinal Surgery, 24, 221-230. https://doi.org/10.1007/s11605-019-04352-4
Waheed, M., Alsenani, M., Al-Akeely, M. and Al-Qahtani, H. (2015) An Unusual Outcome of a Giant Ventral Hernia. Saudi Medical Journal, 36, 983-986. https://doi.org/10.15537/smj.2015.8.11559
Azin, A., Hirpara, D., Jackson, T., Okrainec, A., Elnahas, A., Chadi, S.A. and Quereshy, F.A. (2019) Emergency Laparoscopic and Open Repair of Incarcerated Ventral Hernias: A Multi-Institutional Comparative Analysis with Coarsened Exact Matching. Surgical Endoscopy, 33, 2812-2820. https://doi.org/10.1007/s00464-018-6573-6
AhmedAlenazi, A., Alsharif, M.M., Hussain, M.A., Alenezi, N.G., Alenazi, A.A., Almadani, S.A., et al. (2017) Prevalence, Risk Factors and Character of Abdominal Hernia in Arar City, Northern Saudi Arabia in 2017. Electronic Physician, 9, 4806-4811. https://doi.org/10.19082/4806
Henriksen, N.A., Montgomery, A., Kaufmann, R., Berrevoet, F., East, B., Fischer, J., et al. (2020) Guidelines for Treatment of Umbilical and Epigastric Hernias from the European Hernia Society and Americas Hernia Society. Journal of British Surgery, 107, 171-190. https://doi.org/10.1002/bjs.11489
Smith, J. and Parmely, J.D. (2020) Ventral Hernia. StatPearls.
Holihan, J.L., Karanjawala, B., Ko, A., Askenasy, E.P., Matta, E. J., Gharbaoui, L., et al. (2016) Use of Computed Tomography in Diagnosing Ventral Hernia Recurrence: A Blinded, Prospective, Multispecialty Evaluation. JAMA Surgery, 151, 7-13. https://doi.org/10.1001/jamasurg.2015.2580
Ray-Offor, E. and Okeke, C.J. (2021) Elective Repair of Adult Abdominal Wall Hernia: A Nigerian Tertiary Hospital Experience. European Journal of Medical and Health Sciences, 3, 68-72. https://doi.org/10.24018/ejmed.2021.3.1.668
Rao, A.M.K. (2019) Ventral Hernia: Causes and Management. In: Guttadauro, A., Ed., Techniques and Innovation in Hernia Surgery, IntechOpen, London.
Wolf, L.L., Ejiofor, J.I., Wang, Y., Hunink, M.G., Losina, E., Haider, A.H. and Smink, D.S. (2019) Management of Reducible Ventral Hernias: Clinical Outcomes and Cost-Effectiveness of Repair at Diagnosis versus Watchful Waiting. Annals of Surgery, 269, 358-366. https://doi.org/10.1097/SLA.0000000000002507
Bagwan, L., Patwa, P. and Kumar, K. (2020) Laparoscopic Ventral Hernia Repair: Comparison of Tacker v/s Monofilament Suture. International Journal of Surgery Trauma and Orthopedics, 6, 215-219. https://doi.org/10.17511/ijoso.2020.i03.13
Parker, S.G., Halligan, S., Blackburn, S., Plumb, A.A.O., Archer, L., Mallett, S. and Windsor, A.C.J. (2019) What Exactly Is Meant by “Loss of Domain” for Ventral Hernia? Systematic Review of Definitions. World Journal of Surgery, 43, 396-404. https://doi.org/10.1007/s00268-018-4783-7
Chavan, S.S., Baruah, T.D. and Ganesh Babu, C.P. (2017) A Clinical Study on Ventral Hernias in a Tertiary Care Hospital. International Surgery Journal, 4, 2600-2604. https://doi.org/10.18203/2349-2902.isj20173106
Pastorino, A. and Alshuqayfi, A.A. (2021) Strangulated Hernia. StatPearls.
Germanò, P., Siboni, S., Milito, P., Mautone, G., Resta, M. and Bonavina, L. (2021) Ventral Hernia Repair under Neuraxial Anesthesia. European Surgery, 54, 54-58. https://doi.org/10.1007/s10353-021-00731-x
Lin, M.P., Chen, Y.L. and Shu, G.H. (2018) Diagnosis of a Gangrenous, Strangulated & Incarcerated Inguinal Hernia by Identifying C-Shaped Small Bowel Loops and the Serrated Beak Appearance. Scholarena Journal of Case Reports, 5, 1-3. https://doi.org/10.18875/2375-7043.5.407
Latifi, R. (2020) Ventral Hernia Should Be Treated Surgically, and No One Should Die from It. Surgical Technology International, 39, 204-205. https://doi.org/10.52198/21.STI.39.HR1513
Smiley, A., Levy, L. and Latifi, R. (2021) Risk Factors for Mortality in Patients with Ventral Hernia Admitted Emergently: An Analysis of 48,539 Adult Patients. Surgical Technology International, 39, 183-190 https://doi.org/10.52198/21.STI.39.HR1497