Abstract
Among the advantages of the One Anastomosis Gastric Bypass (OAGB) are the lack of jejuno-jejunal anastomosis and a supposed lower incidence of internal hernia (IH), with only a few cases reported until now. However, the incidence of IH after OAGB is not null. We present a video of the laparoscopic management of an IH that occurred after an OAGB. The patient was a 49-year-old female who had undergone a laparoscopic revisional OAGB 2 years previously after a failed laparoscopic adjustable gastric banding. She was referred to our Unit for recurrent postprandial colicky pain. She lost a total of 50 kg and her body mass index (BMI) dropped from 38 to 19 kg/m2. A CT scan with intravenous contrast showed a swirl of the mesentery around the superior mesenteric artery, without small bowel obstruction. A laparoscopic exploration was performed, confirming the suspicion of IH at the Petersen’s space. An anticlockwise derotation of the whole common limb was performed, and the Petersen’s space was eventually closed with a running non-absorbable suture.
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References
Mahawar KK, Jennings N, Brown J, et al. “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013;23(11):1890–8. eng
Musella M, Susa A, Greco F, et al. The laparoscopic mini-gastric bypass: the Italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc. 2014;28(1):156–63. eng
Lee WJ, Ser KH, Lee YC, et al. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012;22(12):1827–34. eng
Lee WJ, Yu PJ, Wang W, et al. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005;242(1):20–8. eng
Facchiano E, Iannelli A, Lucchese M. Internal hernia after mini-gastric bypass: myth or reality? J Visc Surg. 2016 Jun;153(3):231–2.
Genser L, Carandina S, Soprani A. Petersen's internal hernia complicating a laparoscopic omega loop gastric bypass. Surg Obes Relat Dis. 2015 Sep-Oct;11(5):e33–4.
Kermansaravi M, Kazazi M, Pazouki A. Petersen's space internal hernia after laparoscopic one anastomosis (mini) gastric bypass. Case Rep Surg. 2018;2018:9576120.
Garza Jr E, Kuhn J, Arnold D, et al. Internal hernias after laparoscopic Roux-en-Y gastric bypass. Am J Surg. 2004;188(6):796–800. eng
Iannelli A, Facchiano E, Gugenheim J. Internal hernia after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Obes Surg. 2006;16(10):1265–71. eng
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Facchiano, E., Soricelli, E. & Lucchese, M. Laparoscopic Management of Internal Hernia After One Anastomosis Gastric Bypass (OAGB). OBES SURG 30, 4169–4170 (2020). https://doi.org/10.1007/s11695-020-04791-y
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DOI: https://doi.org/10.1007/s11695-020-04791-y