The retromuscular prosthetic repair of incisional hernias, described by Rives/Stoppa, has proven superior to other open mesh repair techniques. However, as emphatically stated during a symposium "Despite effort to enlighten surgeons about this procedure, many continue to treat incisional hernias with inadequate procedures, like the onlay mesh repair". The retromuscular method was introduced to the american surgeons by George Wants in 1991 and by this author in 1994. Having tried the transcutaneoous suturing technique for fixation of the mesh, as originally described by Rives and Stoppa, and the stapling technique, the latter is safer, faster and significantly simpler.