From 1990, when Laparoscopic Surgery was first introduced, until 2016, that is, for more than 25 years, the techniques available to repair a hernia were few and always the same, without any newer and sophisticated surgical methods.

The advent of robotic machines and their increasingly widespread use throughout the world on the one hand, and the development of new techniques by 2-3 enlightened American surgeons on the other, brought to Greece from 2018 the most advanced techniques for the restoration of abdominal hernias and postoperative hernia. These are the robotic procedures of posterior separation of the abdominal wall, or shorter procedures eTEP (enhanced Total Extra Peritoneal), RS (Rives – Stoppa) and TAR (Transversus Abdominis Release). The first in Greece at the time, Dr. Fotis Archontovasilis, Director of the 6th Surgical Clinic of the Metropolitan General Hospital, successfully applied the first Robotic eTEP-TAR to a patient with multiple recurrences of post-operative abdominal hernia.

A lot has happened at Metropolitan General since then: already having the Da Vinci Xi robotic system in 2018, it significantly upgraded its equipment, trained many nurses and instrument providers in robotic systems, received the title of Center of Excellence in Hernia Surgery in 2019 in Hernia Surgery) from the largest independent American Surgical Certification Board SRC. At the same time, in the same Center of Excellence, Dr. Archontovasilis was put in charge, as Director of the center. At the same time, he was also the first Greek Surgeon to be certified by the same American organization as Master Surgeon and Surgeon of Excellence in Abdominal Wall Hernia Surgery.

In these almost 6 years, the team of Mr. Archontovasilis has performed hundreds of Robotic and Laparoscopic operations with the eTEP, eTEP-RS and eTEP-TAR techniques, with an increasing degree of difficulty, and always with continuous training in his largest centers world.

In June 2024, Dr. Archontovasilis performed for the first time in Greece one of the most complex Robotic hernia repair operations of the abdominal wall. This was a multi-operated patient, with multiple recurrences of abdominal wall hernias (after previous operations), who suffered from two large postoperative abdominal hernias, white line dissection, Spigel’s hernia, and inguinal hernia. That is, he presented almost all the hernias that can be presented to a person.

Using the Da Vinci Xi robotic system, and through only five 8mm holes, all four hernias and the dimension were restored simultaneously. But the most interesting thing was that the technique was used for the first time eTEP with peritoneal flapwithout having to transect the transversus abdominis muscles (TAR method). It is a particularly difficult technique that, however, gives excellent results when performed by highly specialized hernia surgeons.

The entire operation was performed extraperitoneally, without the surgeon having to enter the abdomen at all. It was performed between the patient’s muscle compartments and the meshes used were placed outside the abdomen with full coverage by the peritoneum, without coming into any contact with the intra-abdominal viscera.

The patient’s postoperative course was excellent and he was discharged from the hospital in less than 48 hours.

The absolute expertise of Dr. Archontovassilis and his team in the surgery of abdominal wall hernias and his continuous training throughout the world, the new applied techniques that now offer impressive results, with the fastest discharge of the patient from the hospital, and of course the continuous help and support of Metropolitan General with excellent medical technology equipment, as a certified Center of Excellence, in a safe hospital environment, guarantee an excellent result in the surgical repair of abdominal wall hernias.