Conventional laparoscopic ventral hernia repair (LVHR) without closing the defect (IPUM) has been frequently associated with pseudo-recurrence and bulging since a reconstruction of the linea alba is not performed. On the other hand, LVHR with defect closure, (IPUM plus), is associated with tension and therefore has been associated with pain as the main drawback as well as high bulging rate, particularly in medium-sized hernias. For these reasons, our group developed a novel LVHR technique, Laparoscopic Intraperitoneal Rectus Aponeuroplasty (LIRA), for the treatment of ventral hernia with defects width from 5 to 10 cm. This technique includes three main characteristics and advantages: it is minimally invasive, it involves linea alba restoration, and it is a tension-free repair.