Complex Hernia Repair with Abdominal Wall Reconstruction
Multiple hernia repairs? Mr Steven Karametos is a leading Australian surgeon who specialises in lasting, permanent complex hernia repair with abdominal wall reconstruction.
In recent years, the complexity of patients and difficulty of hernia repair has dramatically increased. A growing number of patients have large or complex hernia and abdominal wall defects. These defects may be the result of an incisional hernia related to multiple abdominal operations, surgical resection of the abdominal wall, or catastrophic injury or infection.
In cases of multiple previous failed hernia repairs or catastrophic injury to the abdominal wall, or for very large hernia, advanced hernia repair techniques are often required to reconstruct the abdominal wall properly.
The goal of complex hernia repair with abdominal wall reconstruction is to repair the hernia defect, reinforce the abdominal wall to prevent recurrences or other hernias from developing, recover abdominal wall functionality, prevent intraabdominal organs from protruding through the abdominal wall, and provide a cosmetically-pleasing appearance. During the procedure, the abdominal muscles may need to be rearranged in order to close the hernia defect. The abdominal wall is then reinforced with mesh which may be absorbable.
At Melbourne Hernia Centre, Mr Steven Karametos is highly skilled in the following world-leading techniques specifically designed to repair ventral and incisional hernia with abdominal wall reconstruction:
eTEP Rives-Stoppa - places mesh in retro-rectus position infront of posterior sheath and away from visceral bowel contents. Utilised for larger incisional ventral hernia.
eTEP TAR - An extension of the eTEP Rives-Stoppa where a transverses abdomens muscle release is incorporated into the repair.
TAPP/Plus - transabdominal preperitoneal with closure of defect. Reserved for ventral, incisional, and flank hernia. Involves lifting a flap of peritoneum, closing the fascial defect then placing and securing an uncoated mesh. The operation is finished with closure of the peritoneal defect. Probably best done robotically.
The end result of this complex abdominal wall reconstruction is a restored, physiologic and functional abdominal wall with enough strength and flexibility to withstand physical activity and to improve quality of life. When performed properly by specially trained surgeons, complex hernia repair generally has a low rate of relapse, resulting in a long-term functional repair with an esthetically-improved result.