ArticleObesity surgery2024
Meticulous Closure of Mesenteric Defects Effectively Reduces the Incidence of Internal Hernia After Laparoscopic Roux-en-Y Gastric Bypass.
Article in Obesity surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Internal hernia after gastrectomy for gastric cancer: total gastrectomy as a potential risk factor.Surgical endoscopy · 2026Article
- Jejunojejunostomy intussusception following conversion from gastric sleeve to gastric bypass: a case report.Journal of surgical case reports · 2026Article
- Article
- Integrating subjective perceptions and objective video analysis to identify challenges in laparoscopic suturing: a cross-sectional study to enhance surgical training.Scientific reports · 2026Article
- Robotic RYGB is Associated with Increased Risk of Early Postoperative Small Bowel Obstruction: an Analysis of 188,213 MBSAQIP Cases.Obesity surgery · 2026Article
- Incidence and management of internal hernia after laparoscopic Roux-en-Y gastric bypass without preventive closure of mesenteric defects: a single-center retrospective study.Updates in surgery · 2025Article
- Petersen's Hernia Following Laparoscopic Roux-en-Y Gastric Bypass: A Retrospective Case Series of Six Patients.Cureus · 2025Article
- Laparoscopic Roux-en-Y Gastric Bypass: Evolution of Weight Loss and Metabolic Obesity-Related Complications After 15-20 Years.Obesity surgery · 2025Article
- Reoperation related to Roux-en-Y jejunal limb after hepaticojejunostomy of choledochal cyst.Pediatric surgery international · 2025Article
- Long-term incidence of bariatric related procedures following laparoscopic gastric bypass: 15 to 20 years single institution experience.Surgical endoscopy · 2025Article
- Role of Mesenteric Defect Closure in Preventing Internal Hernias After Ileocecectomy With Kono-S Anastomosis.Cureus · 2025Article
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5 authors.
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Abstract
introductionInternal hernia (IH) after Roux-Y gastric bypass (RYGB) can lead to extended small bowel ischemia if it not recognized and treated promptly. The aim of this study is to show whether improvement in mesenteric defect (MD) closure reduces the incidence of IH. PATIENTS AND
methodsRetrospective analysis of prospectively collected data from our database including all patients who underwent laparoscopic RYGB between 1999 and 2015. The usual technique was a retrocolic/retrogastric RYGB. We divided patients in four groups according to the closure technique for MD and compared incidences of IH between groups. All patients had at least 8 years of follow-up.
resultsA total of 1927 patients (1497 females/460 males, mean age of 41.5 ± 11 years) were operated. A retrocolic/retrogastric RYGB was performed in 1747 (90.7%) and an antecolic RYGB in 180 patients. Mean duration of follow-up was 15 (8-24) years. 111 patients (5.8%) developed IH, the majority through the jejunojejunostomy (JJ, 3.7%) and Petersen (1.7%) defects. With improvement of closure technique, the incidence decreased over time, from 12.9% in the group with separate sutures to 1.05% in the most recent group with running non-absorbable sutures and an additional purse-string at the JJ defect (p < 0.0001).
conclusionMeticulous closure of MD during RYGB is a very important step that significantly reduces the IH risk after RYGB, even with a retrocolic/retrogastric anatomy. Using running non absorbable braided sutures and an additional purse-string suture at the JJ is the most effective technique, but a small IH risk persists. A high index of suspicion remains necessary in patients who present with acute abdominal pain after RYGB.
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