Latest Laparoscopic Hernia Repair Techniques
Mr Karametos performing a laparoscopic hernia repair
As a world-class specialist hernia surgeon, Mr Karametos is highly skilled in the following advanced laparoscopic hernia repair techniques:
- TEP - Totally extraperitoneal Repair. 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 hernia or femoral hernia.
- I-TEP - a hybrid of laparoscopic TEP and TAPP that facilitate the repair of inguinal hernia that are large, complex or that occur in patients with previous pelvic surgery. It allows for laparoscopic suturing and division of adhesions. This advanced technique is exclusive to Melbourne Hernia Centre.
- 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 transversus 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.
