Chan YW, Fischer W, Pauzenberger C, et al. - Researchers aimed at determining the optimum mesh-tack ratio MTR (mesh area in cm ² divided by the number of fixation tacks) in laparoscopic ventral and incisional hernia repair via comparing IPOM Plus procedures with more intensive mesh fixation vs those with standard mesh fixation. Between 2014 and 2017, 84 patients (mean hernia width 6.6 ± 4.4 cm) intraoperatively received an intensive mesh fixation I-IPOM Plus with MTR ≤ 4:1 (e.g. ,150 cm2 mesh fixed by 50 tacks) and 74 patients (mean hernia width 6.7 ± 3.4 cm) received a standard mesh fixation S-IPOM Plus with MTR > 4:1 (e.g., 150 cm ² mesh fixed by 30 tacks) in this retrospective cohort study. Based on outcomes, they support applying a mesh-tack ratio MTR ≤ 4:1 in laparoscopic IPOM Plus procedures for ventral and incisional hernia patients with multiple recurrence risk factors.