There is a large incisional hernia in relation to a lower right paramedian incision. The incidence of incisional hernia is approximately 10% following abdominal surgery and is much more common when delayed healing is present. This might be due to patient factors such as malnutrition, collagen disorders, advanced malignancy or surgical factors such as poor technique, wound infection, suture material defects. Treatment is by operative repair, either a sutured repair or, more commonly, insertion of a prosthetic mesh. Long term results are, however, poor and re-recurrence often occurs.