Internal Hernia following Laparoscopic Roux-en-Y Gastric Bypass, preventive measures

Abstract

Introduction: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the commonest operations for weight loss surgery especially in the western countries.Internal hernia (IH) can occur following LRYGB and may lead to dreadful complications as small bowel obstruction and strangulation. Objective: To analyze trends of IH after LRYGB and how to prevent it. Methods: A narrative review of the literature was through an online search of the MEDLINE (via PubMed) database, using the following keywords "Obes*", "Gastric Bypass" and "Internal Hernia". Results : Different methods were prescribed for management of mesenteric defects after LRYGB.Closure revealed better out come in front of non-closure technique. Closure with sutures was the most popular and had a superior outcome. Conclusion: Closure of all IH defects after LRYGB defects revealed lower incidence of internal hernias. Superior long-term results came with closure using sutures. There are other methods for closure but still need more evaluation.