This picture shows a 33 x 24 cm monster "Slim-Mesh" ("SM") during its 12-mm port introduction during the fourth phase or last laparoscopic step of the "SM" operation for a 20 x 10 cm massive midline incisional hernia in a class I obese patient.

During the third phase of the "SM" operation, the monster "SM" is also rolled tightly on the operative bench and fixed with multiple stitches, becoming "slim cigarette like" and compact, helping its intrabdominal introduction/orienting/fixation maneuvers during the fourth phase, i.e. the last laparoscopic step of the "SM" operation. The "SM" First Axial Point (Δ FAP) is shown by the surgeon for correct 12-mm port "SM" introduction.

After ensuring that the FAP of the "SM" for the massive ventral hernia (VH) treatment is in the right position, the monster "SM" is quickly and easily introduced into the abdomen through the 12-mm port, without removing or swapping the port for a larger one.

The monster "SM" is used without full-thickness stitches to repair large/giant/massive VH, without loss of domain, i.e. circular or oval-shaped VH larger than 10/15/20 cm in diameter or major axis respectively.

It is used especially to treat massive VH that are equal or larger than 20 cm as mentioned above.