Skills

I completed my training in General Surgery and I practiced for 8+ years as Staff General Surgeon in Florence, Italy.

Fell in love with my Canadian wife Dianna, on September 2009 we came to Canada where I completed 2 years of Fellowship in Minimally Invasive Surgery & Bariatric at the Centre for Minimal Access Surgery (CMAS), Mc Master University, under the guidance of Dr. Mehran Anvari.

During this time I developed a significant skill set in elective as well as acute care surgery of intrabdominal disorders

using minimally invasive technique.


I joined the Department of Surgery at McMaster University on July 2013 as a Clinical Scholar completing my Master’s Degree in Health Science Education in June 2016.


I then joined the Oakville Trafalgar Memorial Hospital on September 2017.


I was also appointed Assistant Clinical Professor with the Department of Surgery, McMaster University on March 2018.

Knowledge & Expertise

I have an interest in minimally invasive techniques for the treatment of diseases of upper GI tract (hiatal hernias, gastric cancer), gallbladder, lower GI tract (diverticular disease, inflammatory bowel diseases, colon and rectal cancer), abdominal wall (ventral and inguinal hernias), solid organs (adrenal, spleen), acute care surgery, upper endoscopy and colonoscopy.

 
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Hiatal Hernia - Laparoscopic Anti-reflux Surgery

Hiatal hernia is when the stomach bulge through the diaphragm causing acid reflux. Having an hiatal hernia does not necessary mean that you need anti-reflux surgery. The mandatory test to be considered for surgery is the 24 hour ph and esophageal manometry. There are different factors to be considered that make you an ideal, or not, candidate for the surgery. These will be discussed at the time of the consultation. For further information about the surgery click the link below from the Society of American Gastrointestinal and Endoscopic Surgeons.

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Gastric Cancer - Laparoscopic Gastrectomy - D2 lymphadenectomy

Gastric cancer begins when cancer cells form in the inner lining of the stomach and tend to spread to the loco-regional nodes. The treatment is multimodal including surgery, chemotherapy and radiotherapy. Gastric surgery with D2 lymphadenectomy represents the main part of the treatment. I bring the experience I developed in Italy in "open" surgery (where the gastric cancer is relatively common) integrating it with the minimally invasive technique and its advantages. The laparoscopic approach reduces the morbidity and mortality of the gastric surgery with D2 lymphadenectomy.  For further information about the treatment  of gastric cancer click the link below from the National Cancer Institute.

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Gallbladder - Gallstones - Laparoscopic cholecystectomy

Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder holds a digestive fluid called bile that's released into your small intestine.

Gallstones range in size from as small as a grain of sand to as large as a golf ball. Some people develop just one gallstone, while others develop many gallstones at the same time. People who experience symptoms from their gallstones usually require gallbladder removal surgery. Gallstones that don't cause any signs and symptoms typically don't need treatment. For further information about the surgery click the link below from the Society of American Gastrointestinal and Endoscopic Surgeons.

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Lower GI tract (diverticular disease, inflammatory bowel diseases, colon and rectal cancer) - Laparoscopic colo-rectal resections

Patients undergo colon surgery for a number of conditions including: colorectal cancer, polyps, inflammatory bowel disease (Crohn’s and ulcerative colitis), colonic inertia, stricture of the colon and diverticulitis. Surgery to remove all or part of your colon is known as colectomy.
Traditional “open” colon surgery procedures may require a single long abdominal incision. Traditional surgery results in an average hospital stay of a week or more and usually 6 weeks of recovery. Less invasive options are available to many patients facing colon surgery. The most common of these is laparoscopic surgery, in which smaller incisions are used. At OTMH we also perform transanal minimally invasive surgery (TAMIS) and transanal total mesorectal excision (TATME). For further information about the surgery click the link below from the Society of American Gastrointestinal and Endoscopic Surgeons.

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Ventral Hernias - Laparoscopic ventral hernias repair

When a ventral hernia occurs, it usually arises in the abdominal wall where a previous surgical incision was made. In this area the abdominal muscles have weakened. A hernia is usually recognized as a bulge under your skin.This can allow a loop of intestines  to push into the sac that can become trapped or “incarcerated" and then die if it gets strangulated" requiring emergency surgery. Laparoscopic ventral hernia repair is a technique to fix tears or openings in the abdominal wall using small incisions, laparoscopes (small telescopes inserted into the abdomen) and a patch (screen or mesh) to reinforce the abdominal wall. It may offer a quicker return to work and normal activities with decreased pain for some patients. For further information about the surgery click the link below from the Society of American Gastrointestinal and Endoscopic Surgeons.

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Inguinal hernias - Laparoscopic inguinal hernias repair

With a history dating back as far as ancient Egyptian culture, inguinal hernia repair is now one of the most commonly performed general surgical procedures in practice. The introduction of a laparoscopic technique has sparked a debate in the literature over the superiority of this method versus open repair. Evidence in the literature does not point to either the laparoscopic or open approaches as the clear superior procedure. Although there is no clear consensus in the literature, laparoscopic surgery seems to have a slightly higher incidence of recurrence (10% vs 14%) while, on the other hand, less post-operative pain and quicker return to work. Surgeon skill in performing the laparoscopic technique and patient preference will dictate the choice between laparoscopic and open repair. For further information about the surgery click the link below from the Society of American Gastrointestinal and Endoscopic Surgeons.

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Adrenal Gland - Laparoscopic adrenalectomy

Diseases of the adrenal gland are relatively rare. The most common reason that a patient may need to have the adrenal gland removed is excess hormone production by a tumor located within the adrenal. Most of these tumors are small and not cancers. They are known as benign growths that can usually be removed with laparoscopic techniques. Removal of the adrenal gland may also be required for certain tumors even if they aren’t producing excess hormones, such as very large tumors or if there is a suspicion that the tumor could be a cancer, or sometimes referred to as malignant. Fortunately, malignant adrenal tumors are rare. An adrenal mass or tumor is sometimes found by chance when a patient gets an ultrasound or a CT-scan study to evaluate another problem. For further information about the surgery click the link below from the Society of American Gastrointestinal and Endoscopic Surgeons.

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Spleen - Laparoscopic splenectomy

There are several reasons why a spleen might need to be removed, and the following list,

though not all inclusive, includes the most common reasons.

- Auto-immune thrombocytopenia purpura (ITP)

- Hemolytic anemia

- Hereditary (genetic) conditions (spherocystosis, sickle cell disease or thalassemia) 

- Malignancy (Rarely, lymphoma or certain types of leukemia, require spleen removal).

- Sometimes the spleen is removed to diagnose or treat a tumor.

- Other reasons: infarct or infection /abscess


For further information about the surgery click the link below from the Society of American Gastrointestinal and Endoscopic Surgeons.

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Acute Care Surgery

Acute care surgery is defined as the urgent assessment and treatment of non-trauma general surgical emergencies  Acute surgical emergencies often represent the most common reason for hospital admission. These conditions include, but are not limited to, acute appendicitis, cholecystitis, diverticulitis, pancreatitis, intestinal obstruction, intestinal ischemia, intra-abdominal sepsis, incarcerated hernias and perforated viscous. Whenever it is possible, I apply the minimally invasive techniques.
Click the link below from the Society of American Gastrointestinal and Endoscopic Surgeons for further information about laparoscopic appendectomy that represents one of the most common surgery performed on-call.

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Upper Endoscopy

Upper Endoscopy (also known as gastroscopy, EGD, or esophagogastroduodenoscopy) is a procedure that enables the surgeon to examine the lining of the esophagus (swallowing tube), stomach and duodenum (first portion of the small intestine). A bendable, lighted tube about the thickness of your little finger is placed through your mouth and into the stomach and duodenum. For further information about the procedure click the link below from the Society of American Gastrointestinal and Endoscopic Surgeons.

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Colonoscopy

Colonoscopy is a procedure that enables the surgeon to examine the lining of the colon and rectum. It is usually done in the hospital or an endoscopic procedure room on an outpatient basis. A soft, bendable tube about the thickness of the index finger is gently inserted into the anus and advanced into the rectum and the colon. For further information about the procedure click the link below from the Society of American Gastrointestinal and Endoscopic Surgeons.