We thank Dr. Miedema for his insightful questions. We agree with his comments that laparoscopic repair of ventral hernias should have long-term results with regard to recurrence rates similar to those for the open mesh hernia repair performed by the underlay technique with adequate mesh overlap of at least 3 cm. However, the true advantage of the laparoscopic approach is that it can achieve this with a much lower incidence of wound infections that also result in hernia recurrence. We refer Dr. Miedema to Dr. Stoppa’s initial report of his technique published in 1989 [1]. …