Use of preperitoneal techniques for moderate sized midline ventral hernia defects can be challenging. Traditionally, retromuscular repairs with possible lateral component separation techniques are used. This video reviews TAPP-RA technique (transabdominal preperitoneal ventral hernia repair with rectus aponeuroplasty) for the management of moderate sized incisional hernias. We review key steps and demonstrates how double-docking strategies can be used to assure broad prosthetic reinforcement for hernia repairs.