Introduction The use of prosthetic materials in the last two decades has produced a dramatic change in the surgical treatment of incisional hernias. However, controversy still exists regarding the type of technique to use (1, 2). Since hos- pital costs have become a major issue, attempts have been made to devise surgical techniques that allow a short hospital stay and early recovery (3). The authors report their experience with incisional hernia repair under local anaesthesia as a day hospital procedure and evaluate its feasibility and outcome, proposing new criteria for the selection of patients. Methods From January 1994 to July 2005, 103 incisional hernia mesh repairs were carried out. Twenty-nine patients (28%) underwent extra-peritoneal hernia repair under local anaesthesia. Twelve patients (41%) were males and 17 (59%) females. Ten patients were older than 65 years. Associated co-morbidities were recorded in 11 patients (38%) that were considered at high anaesthetic risk (5 with coronary artery disease, 3 with diabetes, 1 with cirrhosis, 2 with morbid obesity). A preoperative ultra- sound scan of the abdominal wall was obtained in all patients (Fig. 1). All hernias had a single defect smaller than 10 cm (Table I). The hernial sac was reducible and none of the patients had obstructive symptoms. A single dose of 2 grams of Ceftriaxone was used as intravenous antibiotic prophylaxis. The hernia repair was carried out under local anaes- thesia infiltrated by the operating surgeon. An anaes- thetist was always present in the operating theatre. An intravenous sedation with 2 mg of Midazolam was need- ed in two patients (7%) to reduce situational anxiety. Acta Chir Belg, 2008, 108, 198-202 Day Hospital for Incisional Hernia Repair : Selection Criteria M. Donati, L. Gandolfo, A. Privitera, G. Brancato, A. Donati Department of Surgical Sciences and Organ Transplant, Hernia Service, Catania, Italy. Key words. Incisional hernia ; eventration ; day hospital ; ambulatory surgery. Abstract. Aim : The authors report their experience with incisional hernia repair and set criteria for the safe perform- ance of the procedure on a day hospital basis. Materials and methods : From January 1994 to July 2005, 29 day hospital procedures for incisional hernia were performed under local anaesthesia. Selection criteria included : a hernial defect < 10 cm, a reducible hernial sac and negative history for obstructive symptoms. The repair was achieved with a polypropylene plug in defects < 3 cm and a double layer mesh in larger defects. Results : All patients were discharged within 7 hours of surgery. Postoperative pain was mild and required hospital anal- gesia in 30% of cases. Back at home analgesia was needed in only three patients (10%). Six patients (20%) developed a seroma that reabsorbed spontaneously. During a follow-up ranging 6 to 120 months (mean 75), no recurrence has been recorded. Conclusions : In selected patients, incisional hernia repair as day hospital procedure is feasible, safe and absolutely effective. The use of polypropylene plugs and meshes accounts for a sound repair with low risk of complications. Fig. 1 Ultrasound scan image of a hernial defect (2.5 cm) and sac Original papers