Onset of internal hernia after Roux-en-Y gastric bypass: laparoscopic management
Epublication WebSurg.com, Oct 2014;14(10). URL: http://websurg.com/doi/vd01en4145
Laparoscopic Roux-en-Y gastric bypass (LRYGB) represents the gold standard of treatment for morbidly obese patients. While the laparoscopic approach offers many advantages in terms of fewer wound complications, decreased length of hospital stay, and decreased postoperative pain, certain complications of this operation present difficult clinical problems. The most challenging complication to determine is internal hernia through one of the mesenteric defects. Internal hernias occur more frequently in LRYGB than in the open procedure. This is a significant clinical problem since internal hernia is the most common cause of small bowel obstruction (SBO) after LRYGB, which can result in ischemia or infarction and often requires a reoperation. The incidence of SBO after LGBP is reported to be between 1.8 and 9.7%. The most common site of internal hernia after LGBP is at Petersen’s space. In this video, we present the laparoscopic management of a complete small bowel herniation at Petersen’s space.