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Symptomatic internal hernias after laparoscopic bariatric surgery

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Abstract

Background

The aim of this study was to describe the occurrence and clinical characteristics of symptomatic internal hernias (IH) after laparoscopic bariatric procedures.

Methods

We conducted a retrospective review of cases of IH after 1,064 laparoscopic gastric bypasses (LGB) and biliopancreatic diversions with duodenal switch (LBPD-DS) performed from September 1998 to August 2002.

Results

We documented 35 cases of IH (overall incidence of 3.3%). The IH occurred in 6.0% of patients with retrocolic procedures and 3.3% of patients with antecolic procedures. Most were in the Petersen defect (55.9%) and at the enteroenterostomy site (35.3%). A bimodal presentation was observed, with 22.9% of patients with IH diagnosed in the early postoperative period (2–58 days) and 77.1% in a delayed fashion (187–1,109 days). A laparoscopic approach to the repair of IH was possible in 60.0% of patients. Complications occurred in 18.8% of patients, including one death (2.9%).

Conclusion

Complete closure of all mesenteric defects is strongly recommended during laparoscopic bariatric procedures to avoid IH and their associated complications.

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Authors and Affiliations

  1. Department of Surgery , Centre Hospitalier Universitaire de Sherbrooke, Sherbooke, Quebec, Canada

    E. Comeau

  2. Division of Bariatric Surgery, Department of Surgery, Joan and Stanford I. Weill Medical College of Cornell University, New York Presbyterian Hospital, New York, NY

    M. Gagner & A. Pomp

  3. Division of Endocrine Surgery, Department of Surgery, Columbia University College of Physicians and Surgeons, New York Presbyterian Hospital, New York, NY

    W. B. Inabnet

  4. Division of General Surgery, St. Francis Hospital, Catholic Health Services of Long Island, Roslyn, NY

    D. M. Herron

  5. Department of Surgery, St. Luke’s Medical Center, Milwaukee, WI

    T. M. Quinn

Authors
  1. E. Comeau
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  2. M. Gagner
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  3. W. B. Inabnet
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  4. D. M. Herron
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  5. T. M. Quinn
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  6. A. Pomp
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Corresponding author

Correspondence to M. Gagner.

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Comeau, E., Gagner, M., Inabnet , W.B. et al. Symptomatic internal hernias after laparoscopic bariatric surgery. Surg Endosc 19, 34–39 (2005). https://doi.org/10.1007/s00464-003-8515-0

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  • DOI: https://doi.org/10.1007/s00464-003-8515-0

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