Closed or Unclosed Mesentery? A Meta-analysis of Internal Herniation After Laparoscopic Roux-en-Y Gastric Bypass

Obes Surg. 2023 Jun;33(6):1900-1909. doi: 10.1007/s11695-023-06594-3. Epub 2023 Apr 21.

Abstract

During the laparoscopic Roux-en-Y gastric bypass procedure, closing mesentery or not was still controversial according to preexisted studies. So, the current meta-analysis aimed to compare the outcome of closure versus non-closure of mesenteric defects in laparoscopic Roux-en-Y gastric bypass. Fifteen studies were included, enrolling 53,488 patients. Based on the outcome of analysis, regarding internal hernia, Petersen space's IH, jejunal mesenteric's IH, hospital days, and reoperation, closure of the mesentery was better than non-closure. Besides, small bowel obstruction, anastomosis ulcer, stenosis, leakage, bleeding, gastrointestinal perforation, and postoperative BMI of patients show no difference between non-closure and closure.

Keywords: Internal herniation; Laparoscopic Roux-en-Y gastric bypass; Mesenteric defects; Mesentery; Meta-analysis; Obesity; Small bowel obstruction.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Gastric Bypass* / adverse effects
  • Gastric Bypass* / methods
  • Hernia, Abdominal* / etiology
  • Hernia, Abdominal* / surgery
  • Humans
  • Laparoscopy* / methods
  • Mesentery / surgery
  • Obesity, Morbid* / surgery
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Retrospective Studies