The authors present a group of 24 patients with hernias in scars operated from February 2004 to January 2005 (12 monťhs) using a retromuscular reconstruction proceduře according to Rives. 20 procedure following central laparotomies and 4 procedures following lateral laparotomies were conducted. The defect sizes ranged from 5 to 16 cm. A polypropylene mesh was ušed which was placed between the rectus abdominis muscle and the posterior leaf of the rectus abdominis sheath. The mesh was covered by the fascia with a minimum overlap of 5 cm in all directions. The mean follow- up period was six months (1-12 months) and no early relapses were recorderd. The complications rate was acceptable — lx secondary wound healing, 2x seroma, lx non-transmural MI in a patient with a cardiac ischemic disorder. The retromuscular reconstruction proceduře according to Rives appears to be an appropriate method for management of large ventral hernias with excellent results and minimum complications.

        Key words: ventral hernia - mesh - tension free