Meta-analysis of internal herniation after gastric bypass surgery

Abstract

The present systematic review includes a random-effects meta-analysis. The antecolic procedure, with closure of both the mesenteric and Petersen defects, has the lowest internal herniation incidence following laparoscopic Roux-en-Y gastric bypass.

Predictive value of abdominal CT in evaluating internal herniation after bariatric laparoscopic Roux-en-Y gastric bypass

“…The incidence of internal herniation in symptomatic patients in this study was 2·5 per cent. This is comparable to that in a recent meta‐analysis by Geubbels et al ,. who reported an incidence of 2 per cent among patients who had an antecolic LRYGB with the defects left open.…”

Petersen’s internal hernia complicating a laparoscopic omega loop gastric bypass

“…Clinical presentation is characterized by nonspecific symptoms of obstruction, leading to delayed diagnosis and responsible for small bowel ischemia and even death [7][8][9]. Among the different mesenteric defects that can lead to IH, the Petersen's space accounts for 450% 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 http://dx.doi.org/10.1016/j.soard.2015.05.002 1550-7289/ r 2015 American Society for Metabolic and Bariatric Surgery.…”

“…Initially described after subtotal gastrectomy for peptic ulcer disease or cancer [2][3][4][5][6], this postoperative complication has been reported with increasing frequency after Roux-en-Y gastric bypass (RYGB) [7] and biliopancreatic diversion [8]. Petersen's space is also created after laparoscopic omega loop gastric bypass (OLGB).…”

An easy and reliable method to close Petersen's defect using barbed suture to prevent internal hernia from developing after gastrectomy with Roux‐en‐Y reconstruction

“…Internal hernia developing after gastrectomy with Roux‐en‐Y reconstruction through the antecolic route occurs by intestinal invagination into two defects: the jejuno‐jejunal mesenteric defect, which is formed by the jejunal mesenteries of the Roux limb and afferent limb after jejuno‐jejunal anastomosis, and Petersen's defect, which is formed by the jejunal mesentery of the Roux limb and the transverse colic mesentery . Previous studies recommended closure of both the jejuno‐jejunal mesenteric defect and Petersen's defect to prevent internal hernia after gastrectomy with Roux‐en‐Y reconstruction …”