1. Preoperative

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2. Huge hernia is opened and intestine freed. The deep facia is dissected from the abdominal muscle

3. The submuscular layer is defined

4. The deep fascial layer is closed

5. Mesh is placed beneath the muscle

6. The muscles are closed over the mesh

7. Healed incision after sublay repair of massive incisional hernia

8. Mr John Farmer returning for review after his incisional hernia repair