Advanced Hernia Surgery 

---

Mr Steven Karametos offers a range of both traditional (open) and minimally invasive surgical procedures for hernia repair. Mr Karametos tailors the treatment approach for each patient. How a hernia is fixed will depend on:

• The location and type of hernia
• The extent of the weakness/tear
• A patient’s unique needs and health status

Laparoscopic hernia Repair
Several tiny incisions or keyholes are made in the abdomen. Small instruments guided by a camera are used to repair the hernia with mesh, stitches and/or mechanical fixation. These minimally invasive procedures can result in:

• Less pain
• Shorter hospital stays
• Faster recoveries
• Fewer complications, including a decreased risk of wound infections and chronic nerve pain

Latest Laparoscopic Hernia Repair Techniques
As a specialist laparoscopic hernia surgeon,  Mr Karametos at Melbourne Hernia Centre is highly skilled in the following laparoscopic hernia repair techniques:

• TEP - Totally extraperitoneal. Surgical dissection and mesh placement is performed outside of the peritoneal cavity in the pre-peritoneal space away from the visceral contents. Mesh does not come into contact with bowel or visceral organs. Usually utilised for inguinal or femoral hernia.
• eTEP - Extended view totally extraperitoneal. Same as TEP, but can be utilised for other hernia such as spigelian, ventral, incisional and large inguinal hernia. 
• eTEP Rives-Stoppa - places mesh in retro-rectus position in front of posterior sheath and away from visceral bowel contents. This technique is often utilised for larger incisional ventral hernia with abdominal wall reconstruction.
• eTEP TAR - An extension of the eTEP Rives-Stoppa where a transverses abdominal muscle release is incorporated into the repair. This technique is often utilised for larger incisional ventral hernia with abdominal wall reconstruction.
• TAPP/Plus - transabdominal preperitoneal with closure of defect. This technique is reserved for ventral, incisional, and flank hernia with abdominal wall reconstruction. 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.
• IPOM - Intraabdominal only mesh. This technique places a coated mesh in the abdominal cavity. A relatively quick operation utilised for ventral and incisional hernia, that is reserved for older/frail patients who cannot tolerate a lengthy anaesthetic.

Robotic Hernia Repair
Robotic surgery is a newer technique for repairing hernias. Like laparoscopic surgery, robotic surgery uses a laparoscope, and is performed in the same manner- small incisions, a tiny camera, inflation of the abdomen, and projecting the inside of the abdomen onto television screens. In robotic surgery, however, the surgeon is seated at a console in the operating room, and handles the surgical instruments from the console. While robotic surgery can be used for some smaller hernias, it can also be used to rebuild the abdominal wall. Read more about Robotic Hernia Repair. 

​Open Hernia Surgery 
An incision is made near the hernia or through a previous incision. If there is protruding tissue, it will be pushed back into place, and Mr Karametos will repair the weak spot where the hernia occurred. More complex hernia procedures may involve reconstructing and/or rearranging muscles and connective tissue in the abdomen to repair the hernia. In these cases Mr Karametos may use a patient’s own tissue (called flaps) and surgical mesh to help strengthen the abdominal wall, restore function and prevent another hernia.

Biosynthetic Absorbable Mesh 
In recent years, biosynthetic absorbable mesh has become available for some types of hernia surgery. Mr Karametos is one of the leading hernia surgeons in Australia who specialises in using the absorbable mesh. After surgery, It disappears completely leaving behind collagen that strengthens the repair. Its key benefits are as follows. Read more about Absorbable Bio Hernia Mesh.

• Innovative material: Uniquely designed web of biocompatible synthetic polymers that is gradually absorbed by the body
• Alternative to biologics: As a biosynthetic tissue-building scaffold, it is not derived from human or animal tissue but engineered for uniformity, consistency, and versatility
• Consistent absorption: Absorbed within six to seven months, leaving no permanent material behind in the body
• Quality tissue fast: Facilitates rapid cellular infiltration and vascularisation

​Traditional Mesh 
The traditional mesh is a woven sheet of surgical-grade material – is often used to strengthen or repair weakened areas in the abdomen and reduce the chances the hernia will come back. Using mesh also reduces pain and tension on the surgical wound. It can be placed through both laparoscopic and open procedures. Mr Karametos has extensive experience in safely using these materials in thousands of patients. We also follow up with patients to make sure what we do today and long-term is safe, prevents hernias from happening again and preserves quality of life. 

Melbourne Hernia Centre
"Uncompromising Excellence. Commitment to Care."

Understanding Hernias
Hernia Causes and Risk Factors
Types of Hernias We Treat
Complex Hernia
Advanced Hernia Surgery Options 
Absorbable Mesh
​After Hernia Surgery

About
Our Surgeon 
Our Staff
Insurance and Cost 

Contact
Phone: 03 9857 3600
reception@stevenkarametos.com.au
stevenkarametos.com.au

Operating: Knox Private Hospital
                     Mitcham Private Hospital 
​                     Peninsula Private Hospital 
​                     Holmesglen Private Hospital