<p>In ventral and incisional hernias a mesh-based open or minimally invasive repair is the base of surgical approach. To minimize complications of the existing open and laparoscopic techniques the endoscopic Mini- or Less-Open Sublay (eMILOS) concept was developed. In 2019 we decided to establish e MILOS as the favourite procedure for umbilical and small ventral hernias combined with rectus diastasis at our hernia center. After successful establishment of this technique we implemented this technique also for small incisional hernias with combined rectus diastasis. Since 2019 243 eMILOS and 72 MILOS procedures in 78 female and 237 male patients were performed at our hernia center. 105 were incisional and 210 ventral hernias with combined rectus diastasis. The average size of the hernias was 4cm, average supraumbilical size of the rectus diastasis was 5cm. In 9 patients a surgical revision was necessary: one because of infection and abscess formation, 4 because of hernia recurrence and 4 because of postoperative bleeding and haematoma.</p><p>At our hernia center e MILOS is an established and standardized technique with low recurrence and complication rates after repair of incisional and ventral hernias with combined rectus diastasis.</p>