Symptomatic internal hernias after laparoscopic bariatric surgery

E. Comeau, M. Gagner, W. B. Inabnet, D. M. Herron, T. M. Quinn, A. Pomp

Research output: Contribution to journalReview articlepeer-review

125 Scopus citations

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

Original languageEnglish
Pages (from-to)34-39
Number of pages6
JournalSurgical Endoscopy and Other Interventional Techniques
Volume19
Issue number1
DOIs
StatePublished - Jan 2005

Keywords

  • Bariatric surgery
  • Internal hernias
  • Laparoscopic reoperative surgery
  • Mesenteric defects
  • Small bowel obstruction

ASJC Scopus subject areas

  • Surgery

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