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Internal Hernia After Laparoscopic Roux-en-Y Gastric Bypass for Morbid Obesity

Overview
Journal Obes Surg
Date 2006 Oct 25
PMID 17059733
Citations 75
Authors
Antonio Iannelli
Enrico Facchiano
Jean Gugenheim
Affiliations
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Abstract

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is associated with a relatively high incidence of internal hernias (IH) when compared to the open operation.

Methods: A search in PubMed MEDLINE from January 1994 through January 2006 was performed (keywords: obesity, laparoscopy, gastric bypass and internal hernia).

Results: 26 studies with a total of 11,918 patients were considered. 300 cases of IH occurred (rate 2.51%). IH occurred 116 times at the level of the transverse colon mesentery (69%), 30 at the Petersen's space (18%), and 22 at the entero-enterostomy site (13%). 142 re-operations were performed laparoscopically (85.6%), and 24 by laparotomy (14.4%). Bowel resection was done in 5 cases (4.7%). Mortality was 1.17%.

Conclusions: IH after LRYGBP has an incidence of 2.51%. Closure of mesenteric defects with non-absorbable running suture and antecolic Roux limb are recommended. Surgical exploration for suspicion of IH after LRYGBP should be first done by laparoscopy.

Citing Articles

Multiple Internal Hernias: A Complication of Laparoscopic Roux-en-Y Gastric Bypass.

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Comparison between the mesenteric fixation method (MEFIX) and conventional methods at preventing the occurrence of Petersen's hernia: a study protocol for a multicenter randomized controlled trial.

Park J, Kim D, Jeon T, Jeong S, Kim T, Min J Trials. 2024; 25(1):7.

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Laparoscopic repair of internal hernia in one anastomosis gastric bypass (OAGB): a case report.

Al-Mulla A, Elgazzar M, Shalaby O J Surg Case Rep. 2023; 2023(12):rjad670.

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An insidious internal hernia 30 years after jejunoileal bypass: a case report.

Palomaki V, Palomurto S, Venesmaa S, Kakela P J Surg Case Rep. 2023; 2023(12):rjad665.

PMID: 38076315 PMC: 10701789. DOI: 10.1093/jscr/rjad665.

A paradoxical internal hernia at Brolin's anti-obstruction stitch following Roux-en-Y gastric bypass: a case report.

Patel K, Serapiglia V, Rizzo A, Varre J, Sonnanstine T J Surg Case Rep. 2023; 2023(10):rjad554.

PMID: 37867920 PMC: 10587004. DOI: 10.1093/jscr/rjad554.