Following laparotomies, the rate of incisional hernia is 5-20%, and in high-risk patients more than 30%. The current literature suggests the use of a transverse incision if pos-sible, a suture technique with small bites, and a wound: suture length ratio of 1:4. Recent studies have shown, that the use of prophylactic mesh in an onlay position could have a significant effect on decreasing the rate of incisional hernia. There is still a lack of knowledge on potential long-term complications, but recommending prophylactic onlay mesh should be considered in all patients at risk of incisional hernia.