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Among postoperative incisional hernias, mid-epigastric eventrations have peculiar features for physiopathological reasons that are summed up in general and specifically in the first paragraph of this paper; they are characterized by the quick retraction of the lateral belt, with the chondrocostal margin of the thorax participating as the upper limit of the cleft, and by the rapidly irreducible diastasis--hence the importance of an early decision to operate. The authors propose three regular procedures with which they are experienced: repair with a large retromuscular nonabsorbable synthetic tulle prosthesis for extensive epigastric eventrations, fillup aponeuroplasty using the sheath of the rectus abdominis associated with a premuscular patch in case of diastasis or of multiple superimposed orifices and suture associated with a small retromuscular auxiliary patch to treat small incisional hernias. The article, mainly dealing with the technical details of the three procedures and of their variants, is concluded by a brief report of the personal results obtained with a series of 616 postoperative eventrations, including 91 mid-epigastric ones, controlled after an average time lapse of 5.5 years.

During many years the use of prosthesis for abdominal wall repair was not accepted by all surgeons. Now the laparoscopic repair has brought some surgeons to do it nearly systematically and industry proposes new materials. To allow comparing new materials the authors have developed an experimental proceeding of which they analyse technical difficulties and limits.

The subparietal cleavable spaces in the abdomen were studied with the view to their practical application in general surgical practice. These studies formed part of an applid anatomy research project on the repair of anterolateral gaps in the abdominal wall, using large prostheses, inserted without direct fixation, as a means of reinforcement of the visceral sac. The spaces were meeasured at different levels in 20 adult cadavers, and the values obtained were used to prepare representations on a plane surface. These morphological and metric data should enable the surgeon to make his incisions more easily, and to obtain a more effective insertion and use of prostheses for reinforcement of the peritoneal sac, thus avoiding the waste of time and material, and the various difficulties usually encountered.