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I thank Drs. Carbonell, Matthews, Kercher and Heniford for their comments. The point of the article [2] however, was not to raise issues about mesh fixation or even mesh material. We wanted only to indicate a simple and reliable technique for introducing a bulky mesh inside the abdominal cavity during incisional hernia repair. The purpose was to avoid the use of 12-mm trocars or even larger incisions for mesh introduction because these induce fascia defects that must be closed [1] which can be very cumbersome. This method of mesh introduction obviously does not preclude fixing the prosthesis with tacks and sutures, or indeed with sutures alone. …