Résumé : Having found existing techniques for treatment of incisional hernias unsatisfactory, we developed a new laparoscopic approach with a Parietex Composite mesh. This study shows the preliminary results in order to analyze the validity of the concept on efficacy and safety. Three trocars are needed for this procedure. Non-reabsorbable sutures are mandatory for closure of large defects to avoid having to ultimately extrude the mesh. Ten to 12 cardinal stitches are applied on the polyester side of the mesh. The mesh is anchored to the anterior abdominal wall by transabdominal non-reabsorbable sutures without the use of staples or tacks. One hundred twenty patients with ventral and incisional hernias were included in this study. Early and late complications are reported, showing lower rates of morbidity and no mortality. This technique is satisfactory on the technical front, and the results are as good, or better, than in other trials. © Springer-Verlag 2003.