Purpose A classification for primary and incisional abdominal wall hernias is needed to allow comparison of publications and future studies on these hernias. It is important to know whether the populations described in different studies are comparable. Methods Several members of the EHS board and some invitees gathered for 2 days to discuss the development of an EHS classification for primary and incisional abdominal wall hernias. Results To distinguish primary and incisional abdominal wall hernias, a separate classification based on localisation and size as the major risk factors was proposed. Further data are needed to define the optimal size variable for classification of incisional hernias in order to distinguish subgroups with differences in outcome. Conclusions A classification for primary abdominal wall hernias and a division into subgroups for incisional Hernia (2009) 13:407-414 DOI 10.1007 abdominal wall hernias, concerning the localisation of the hernia, was formulated.

Laparoscopic ventral hernia treatment using Parietex composite mesh is an effective and safe procedure. Morbidity and recurrence rates are low, and the 2-year outcomes are promising, with no prosthesis migration or complication related to intraperitoneal positioning of the mesh.

Our long series confirms the unexpected high rate of feasibility in the suturing concept or augmentation technique, and confers additional benefits to the conventional advantages of LIVHR in terms of reducing the overall morbidity, with a low rate of recurrences. Based on our experience and study, the current best indications for a successful LIVHR procedure should be tailored upon the limitations of the defect's width and proper patient selection, to restore adequately the optimal functionality of the abdominal muscles and provide better functional and cosmetic outcomes.

The most disturbing complications of gastric banding technique are gastric perforation and pouch dilation. Their incidence may be reduced by improving the technique and by considering pitfalls of the procedure.

With the double-suturing technique used for LIVHR and the use of a composite mesh, we observed a low rate of recurrences and limited side effects as compared with the use of tacks intra-abdominally. Redo surgeries after LIVHR are feasible, but care must be taken due to unpredictable mesh adhesions.