title: Symptomatic internal hernias after laparoscopic bariatric surgery.
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%).
  
  
  CONCLUSIONS
  Complete closure of all mesenteric defects is strongly recommended during laparoscopic bariatric procedures to avoid IH and their associated complications.
authors.affiliation: Department of Surgery , Centre Hospitalier Universitaire de Sherbrooke, Sherbooke, Quebec, Canada.
authors.forename: E
authors.initials: E
authors.lastname: Comeau
authors.forename: M
authors.initials: M
authors.lastname: Gagner
authors.forename: W B
authors.initials: WB
authors.lastname: Inabnet
authors.forename: D M
authors.initials: DM
authors.lastname: Herron
authors.forename: T M
authors.initials: TM
authors.lastname: Quinn
authors.forename: A
authors.initials: A
authors.lastname: Pomp
mesh_terms: D050110:Bariatric Surgery / Q000009:adverse effects* / Q000379:methods*; D006547:Hernia / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D012189:Retrospective Studies