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. 2023 Feb;33(2):506-512.
doi: 10.1007/s11695-022-06411-3. Epub 2022 Dec 24.

Effect of Suture Used for Closure of Mesenteric Defects After Laparoscopic Roux-en-Y Gastric Bypass: Single-Center Study

Lynn Verrelst  1   2 , Magali Blockhuys  3 , Leo Hendrickx  3 , Bart Gypen  3 , Jody Valk  3 , Stijn Heyman  3 , Dirk Vervloessem  3 , Frank van Sprundel  3
Affiliations

Effect of Suture Used for Closure of Mesenteric Defects After Laparoscopic Roux-en-Y Gastric Bypass: Single-Center Study

Lynn Verrelst et al. Obes Surg. 2023 Feb.

Abstract

Introduction: Small bowel obstruction (SBO) due to internal herniation (IH) is a well-known complication of laparoscopic Roux-en-Y gastric bypass (LRYGBP). The objective of this study is to evaluate different types of non-absorbable sutures used for closure of the defects regarding the incidence of SBO due to IH/adhesions, adhesion formation in general, or reopening of the defects.

Methods: A single-center retrospective study was performed. Patients who underwent LRYGBP were divided in 3 groups: group A closure of the defects with monofilament Polypropylene suture (Prolene®), group B with braided polyester suture (Ethibond®), group C with barbed knotless Polybutester suture (V-Loc®). Descriptive statistics were performed regarding SBO due to IH/adhesions, adhesion formation, and reopening of closed defects.

Results: From 5145 patients, 224 patients underwent exploratory laparoscopy for suspicion of SBO. Mean time interval was 28.4 months. IH or intermittent IH was found in 1.94% in group A, 1.78% in group B, and 1.40% in group C. Obstruction due to adhesions was found in 0.70%, 0.36%, and 0.42% per group, respectively. Adhesions in general were observed in 1.47% in group A, 1.43% in group B, and 1.06% in group C. The incidence of reopening was higher in group A (2.24%) in comparison with group B (1.13%, P = 0.041) and group C (1.05%, P = 0.001).

Conclusions: After descriptive analysis, these results can withhold no difference among the 3 non-absorbable sutures regarding incidence of SBO due to IH or SBO due to adhesions, yet tendency for higher reopening rates after closure with monofilament Polypropylene suture is observed.

Keywords: Internal herniation; Laparoscopic gastric bypass; Postoperative complications; Small bowel obstruction.

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References

    1. Brammerloo YGA, Vannijvel M, Devriendt S, et al. Internal hernia after laparoscopic gastric bypass without preventive closure of mesenteric defects: a single institution’s experience. J Gastrointest Surg. 2021;25(3):623–34. - DOI
    1. Magouliotis DE, Tzovaras G, Tasiopoulou VS, et al. Closure of mesenteric defects in laparoscopic gastric bypass: a meta-analysis. Obes Surg. 2020;30(5):1935–43. - DOI
    1. Nuytens F, D’Hondt M, Van Rooy F, et al. Closure of mesenteric defects is associated with a higher incidence of small bowel obstruction due to adhesions after laparoscopic antecolic Roux-en-Y gastric bypass: a retrospective cohort study. Int J Surg. 2019;71:149–55. - DOI
    1. Aghajani E, Jacobsen HJ, Nergaard BJ, et al. Internal hernia after gastric bypass: a new and simplified technique for laparoscopic primary closure of the mesenteric defects. J Gastrointest Surg. 2012;16:641–5. - DOI
    1. Rosas U, Ahmed S, Leva N, et al. Mesenteric defect closure in laparoscopic Roux-en-Y gastric bypass: a randomized controlled trial. Surg Endosc. 2015;29(9):2486–90. - DOI

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