title: Laparoscopic technique for hernia reduction and mesenteric defect closure in patients with internal hernia as a postoperative complication of laparoscopic Roux-en-Y gastric bypass.
abstract: Internal hernia is a relatively common complication of laparoscopic Roux-en-Y gastric bypass. Laparoscopic treatment may be a challenge for nonbariatric surgeons if small-bowel obstruction is present. The aim of this paper is to present a systematic laparoscopic technique for hernia reduction and mesenteric defect closure in patients with small-bowel obstruction due to an internal hernia as a postoperative complication of laparoscopic Roux-en-Y gastric bypass. From February 2007 to May 2011, this technique was used in 41 consecutive patients. One case was converted to an open approach due to extensive bowel necrosis. There were no complications related to the technique but 2 patients suffered pulmonary aspiration during anesthesia. After the internal hernia repair patients reported no further abdominal symptoms. Treatment of small-bowel obstruction due to an internal hernia should be attempted by laparoscopy except in the setting of bowel necrosis. The technique presented in this article represents a safe and effective option for the management of this complication.
authors.affiliation: Department of Surgery, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela. jlleyba@yahoo.es
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Leyba
authors.forename: Salvador
authors.initials: S
authors.lastname: Navarrete
authors.forename: Salvador
authors.initials: S
authors.lastname: Navarrete Llopis
authors.forename: Nestor
authors.initials: N
authors.lastname: Sanchez
authors.forename: Adriana
authors.initials: A
authors.lastname: Gamboa
mesh_terms: D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D046449:Hernia, Abdominal / Q000209:etiology / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008643:Mesentery / Q000601:surgery; D009767:Obesity, Morbid / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery; D013536:Suture Techniques