Since the publication of Igor Belyansky’s seminal paper in 2017, the author has consistently preferred the eTEP technique for the majority of ventral and incisional hernia repairs [4]. The primary advantage of this retromuscular approach is the avoidance of an intraperitoneal prosthesis, thereby reducing the risk of potential long-term complications associated with it. Additionally, the eTEP technique allows for the placement of a larger, uncoated mesh prosthesis, which is both cost-effective and durable. The method also provides some myofascial medialization, helping close fascial defects. Patients often benefit from a smoother postoperative recovery with less pain, largely due to the minimal or absent need for mesh fixation.