title: Zero frequency of internal hernias after laparoscopic double loop gastric bypass without closure of mesenteric defects.
abstract: OBJECTIVE
  Laparoscopic Roux-en-Y gastric bypass is among the most effective surgical procedures for morbid obesity; however, one of its most common long-term complications is internal hernia. The purpose of this study was to evaluate the incidence of internal hernia in patients undergoing a new gastric bypass surgical technique known as "double loop" without closure of the mesenteric defects.
  
  
  METHODS
  We reviewed 44 patients with morbid obesity, who underwent laparoscopic double loop gastric bypass. There were 34 women and 10 men, followed up for a mean period of 18 ± 3 months, mainly by periodic medical examinations and blood tests.
  
  
  RESULTS
  The initial body mass index (BMI) was 44.23 ± 4.7 and the mean % excess weight (%EW) was 105.83 ± 24.41. After 18 postoperative months, the mean BMI was 29.68 ± 3.7 kg/m(2), representing a mean loss of 14.5 BMI units, with the mean % excess weight loss (%EWL) of 64.33 ± 13.47. No cases of internal hernia were recorded.
  
  
  CONCLUSIONS
  Laparoscopic double loop gastric bypass without closure of the mesenteric defects is a safe and feasible procedure. A longer observational follow-up and a large number of patients are required to confirm significant results.
authors.affiliation: Department of Medical, Surgical and Health Sciences, General Surgery Clinic, University Hospital of Trieste, Strada di Fiume, 447, Trieste, Italy, spalmisano@units.it.
authors.forename: Silvia
authors.initials: S
authors.lastname: Palmisano
authors.forename: Michela
authors.initials: M
authors.lastname: Giuricin
authors.forename: Biagio
authors.initials: B
authors.lastname: Casagranda
authors.forename: Nicolò
authors.initials: N
authors.lastname: de Manzini
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006547:Hernia / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008643:Mesentery / Q000002:abnormalities / Q000601:surgery; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome