As per EHS classification, a primary, direct inguinal hernia with 4 cm width would be
High-Yield Explanation
The European Hernia Society has suggested a simplified system of classificationPrimary or recurrent (P or R);Lateral, medial or femoral (L, M or F);Defect size in fingerbreadths (each finger is assumed to be 1.5 cm.)Ex1) A primary, direct inguinal hernia with 4 cm width would be PM3Ex 2) A Recurrent, indirect, inguinal hernia with a 3-cm defect size would be RL2Ref: Bailey and love 27e pg: 1031