Hernia Surgery Sydney eTEP

I recently visited a world renowned hernia surgeon in Tokyo, Japan. His name is Imamura Kiyotaka and he focuses solely on surgery and advancing surgery techniques and care of patients suffering with hernias. He operates at the Yotsuya Medical Cube in Tokyo. I had been looking offer this hernia surgery in Sydney.

Having performed thousands of hernia operations myself, and undertaking many types of laparoscopic surgery, over the years I could envisage how repairing a ventral hernia (such as umbilical hernia or incisional hernia) by placing a mesh by KEYHOLE surgery directly underneath the rectus muscles (“6 pack muscles”!)  would be very well tolerated by patients and provide a strong long term repair. It also improves the appearance of function of the abdominal wall and the abdominal wall muscles. This technique has been developed and requires advanced surgical skills and careful knowledge of the abdominal wall muscles (published article here). This is not a common technique used in hernia surgery in Sydney currently. The technique is called “eTEP” which stands for “Enhanced-view Totally Extraperitoneal” approach and allows techniques of open surgery by Rives-Stoppa to be performed laparoscopically.

The benefits are:

1. Keyhole/laparoscopic access rather than a large surgery scar
2. Placement of mesh in the the best plane of the abdominal wall muscles. Mesh is not in contact with the bowel.
3. Clear visualisation of this plane, with minimal disruption of the muscles, to allow accurate coverage and repair of the hernia
4. Repair of multiple layers of the hernia defect (‘hole’)
5. Allows ‘release’ of the muscles to reduce tension on the repair which reduces chances of the hernia coming back.
6. It is now more feasible to repair large difficult to treat hernias that have arisen from previous surgery scars, which previously may not have been treated due to size, risk, difficulty and high changes of recurrence of the hernia

I am excited to perform and offer this surgery. It is very satisfying using such accurate techniques during this surgery, and seeing the results for patients afterwards!

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