Аннотация:Based on the experience of treatment of 550 patients with anterior abdominal wall hernia, an approach to surgical treatment of such patients was developed. Prosthetic methods of hernioplasty have undeniable advantages over the hernioplasty with local tissue. Among the prosthetic methods, the most preferable is the reconstruction of the anterior abdominal wall with the help of a submuscular prosthesis (“sublay”). In case if such an operation is unfeasible due to a vast defect of the anterior abdominal wall that does not allow bringing together the margins of the aponeurosis without causing tension, it is better to correct the abdominal wall (“inlay”). If the latter is unfeasible, too, the Ramirez-procedure should be performed. Functionally, the correction of the abdominal wall (“inlay”) is the least profitable modification of prosthetic hernioplasty because the linea alba is not restored. This is why for middle aged patients with vast defects of the abdominal wall, who require appropriate physical rehabilitation, indications for the Ramirez procedure can also be established, as this technique allows moving the rectus sheaths medially.