Conclusions  Elimination of tack fixation of mesh in TEP inguinal hernia repair is associated with decreased operative cost and significantly reduce operative time and in-hospital stay, but no difference in the risk of hernia recurrence, complications, and postoperative pain. For more detailed evaluation, further well-structured trials with improved standardization of hernia type, operative technique, and surgeon experience are necessary. Content Type Journal ArticleDOI 10.1007/s00268-010-0760-5Authors Ka-Wai Tam, Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei, 110 TaiwanHung-Hua Liang, Division of General Surgery, Department of Surgery, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taip...