Obesity Surgery

, Volume 16, Issue 10, pp 1265–1271

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

Authors

  • Antonio Iannelli
  • Enrico Facchiano
  • Jean Gugenheim
Article

DOI: 10.1381/096089206778663689

Cite this article as:
Iannelli, A., Facchiano, E. & Gugenheim, J. OBES SURG (2006) 16: 1265. doi:10.1381/096089206778663689

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.

MORBID OBESITYLAPAROSCOPYGASTRIC BYPASSINTERNAL HERNIA
Download to read the full article text

Copyright information

© Springer 2006