| Grade B | Suture fixation alone or a combination with tacks should be performed. |
| Grade C | The tacks-only fixation can be considered the technique of choice, taking into account the increased risk of postoperative pain due to the number of devices and the need for an additional overlap of mesh (at least 5 cm) to prevent recurrence caused by shrinkage. |
| Additional glue fixation reduces the need for penetrating fixation devices and hence decreases postoperative pain and device-induced hernia. |
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