The document discusses the debate around whether mesh should be tacked or not during laparoscopic hernia repair surgery. It summarizes several studies that found: 1) There was no difference in hernia recurrence rates whether the mesh was tacked or not. 2) Patients who did not have their mesh tacked experienced less post-operative pain and required fewer pain medications. 3) Tacking the mesh increased the cost and time of the surgery without providing clinical benefits. Therefore, the document concludes that laparoscopic hernia repair can be performed safely without the routine use of mesh fixation devices.