Alternative Method of Mesenteric Defect Closure after Roux-en-Y Gastric Bypass
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Roux-en-Y gastric bypass is the gold standard for weight loss surgery. This procedure creates two to three mesenteric defects, depending on ante-colic versus retro-colic technique. Current literature supports mesenteric defect closure, but there is no consensus on how to best close these defects. Described options include running separate suture lines for each defect, or employing endoscopic staplers for defect closure.
This is a video/dynamic manuscript on operative technique.
We describe an alternative technique that does not require an extra laparoscopic instrument and is more efficient than traditional suture lines due to less suturing.
The technique maintains low gastric bypass complication rates by closing mesenteric defects, while keeping intra-operative costs low, and minimizing time spent on the defect closures.
KeywordsMesenteric defect Internal hernia Gastric bypass Closure Technique One suture
Conception, design, overall responsibility: TS
Writing the article: EW, TS
Critical revision of the article: TS
Final approval of the article: TS
Compliance with Ethical Standards
Funding and Conflict of Interest Statement
The authors (Author 1, Author 2) declare no conflicts of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Informed Consent and Human Rights Statement
Does not apply
(MP4 280,474 kb)
- 1.English WJ, DeMaria EJ, Brethauer SA, et al. American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016. Surg Obes Relat Dis. 2018;14(12):1637–9.Google Scholar
- 9.Leyba JL, Navarrete S, Navarrete Llopis S, et al. 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. Surg Laparosc Endosc Percutan Tech. 2012;22(4):182–5.CrossRefGoogle Scholar
- 12.Kristensen SD, Naver L, Jess P, et al. Effect of closure of the mesenteric defect during laparoscopic gastric bypass and prevention of internal hernia. Dan Med J. 2014;61(6):A4854.Google Scholar