Level 1B	The method used for mesh fixation (sutures and/or tacks) has no influence on acute postoperative pain.
	Suture fixation of the mesh incurs a significantly longer operation time than fixation by tacks.
	The absorbability of the suture material used for mesh fixation is not related to the incidence of postoperative pain.
	Tacks-only fixation is associated with a significantly higher grade of mesh shrinkage in the horizontal direction than transfascial suture fixation.
	In umbilical hernias with a defect size up to 5 cm, mesh fixation by glue results in less acute postoperative pain than fixation by tacks.
Level 3	The incidence of acute postoperative pain correlates significantly with the number of tacks used for mesh fixation.
Level 4	The recurrence rates do not differ between the different fixation techniques.
	Application intervals of 1.5 cm for the staples/tacks in the single- or double-crown technique are associated with a low recurrence rate.
	The type of mesh fixation technique does not influence the incidence of postoperative chronic pain.
	The use of resorbable penetrating fixation devices achieves sufficient tensile strength and low recurrence rates.
	The use of additional glue fixation increases the efficacy of fixation and postoperative pain.
Level 5	Penetrating fixation devices (e.g., transfascial sutures, protruding tacks) can cause incisional hernias and in the pericardial region may result in a cardiac tamponade.