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Incisional hernias in the midline of the abdomen are a common condition requiring surgery, often influenced by factors like surgical technique, obesity, and other health issues. This trial evaluates and compares two types of mesh repairs for these hernias: the Ventralex patch placed in a sublay position and the Progrip self-fixating mesh placed in an onlay position. The study aims to understand the differences in outcomes between these two repair methods, as current evidence on the Ventralex patch is limited and mixed regarding effectiveness and recurrence rates. Participants will undergo surgery using either the Ventralex patch implanted in the sublay position or the Progrip mesh placed in the onlay position. Both are mesh devices used to reinforce the hernia repair, but they differ in placement and design. The study compares these two approaches directly to determine which may lead to better results in repairing midline incisional hernias. During the study, researchers will monitor participants for one year after surgery to measure the rate of hernia recurrence. Assessments will likely include clinical evaluations and follow-up visits to track healing and any complications. This one-year follow-up period will help determine the effectiveness and durability of each mesh repair method in preventing the hernia from returning.