Zero frequency of internal hernias after laparoscopic double loop gastric bypass without closure of mesenteric defects

Surg Today. 2014 Oct;44(10):1920-4. doi: 10.1007/s00595-014-0916-2. Epub 2014 May 9.

Abstract

Purpose: 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.

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Gastric Bypass / methods*
  • Hernia / epidemiology*
  • Humans
  • Incidence
  • Laparoscopy / methods*
  • Male
  • Mesentery / abnormalities
  • Mesentery / surgery
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome