Ramirez technique of components separation using a sublay and onlay Biodesign mesh on a patient with a Grade 3 incisional hernia. A) Rectus sheath mobilised. B) Rectus sheath now free laterally. C) Sheath incised vertically, lateral to semilunaris. D) Posterior layer is closed. E) A sublay Biodesign graft is sutured in place. F) Remnants of graft are sutured over the lateral releasing incisions.