Our video shows an open perineal hernia mesh repair through a Pfannenstiel incision. A fifty-seven year old woman known for a retro-rectal neuro-endocrine tumour (NET-G2) initially underwent a local excision with coccygectomy. Abdomino-perineal resection and lymphadenectomy was performed two years later for local recurrences. This article is protected by copyright. All rights reserved.