Hernia repair using a mesh patch and a placement tool is described. The placement tool includes a plurality of adjustable blades and a control to move the adjustable blades between a clustered position that allows the blades to be inserted in an opening in a ply of the mesh patch and an expanded position to spread the mesh patch out in a planar fashion. Repair of a hernia includes compressing the mesh patch, inserting the adjustable blades of a placement tool into the opening in the mesh patch, inserting the mesh patch and tool into a patient, moving the adjustable blades from the clustered position to the expanded position, affixing the mesh patch to the patient, moving the adjustable blades from the expanded position to the clustered position, and removing the placement tool from the mesh patch and the patient.