Preventing Peterson’s space hernia using a BIO synthetic mesh
Abstract Background Internal hernias occur after Roux-en-Y gastric bypass surgery (RYGB) when small bowel herniates into the intermesenteric spaces that have been created. The closure technique used is related to the internal hernia risks outcomes. Using a non-resorbable double layered suture, this...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-05-01
|
| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-021-01197-0 |
| _version_ | 1818943345744936960 |
|---|---|
| author | Adam Skidmore Edo O. Aarts |
| author_facet | Adam Skidmore Edo O. Aarts |
| author_sort | Adam Skidmore |
| collection | DOAJ |
| description | Abstract Background Internal hernias occur after Roux-en-Y gastric bypass surgery (RYGB) when small bowel herniates into the intermesenteric spaces that have been created. The closure technique used is related to the internal hernia risks outcomes. Using a non-resorbable double layered suture, this risk can be significantly reduced from 8.9 to 2.5% in the first three postoperative years. By closing over a BIO mesh, the risk might be reduced even more. Setting Two large private hospitals specialized in bariatric surgery. Methods All patients receiving a RYGB for (morbid) obesity between 2014 and 2018 were included in this retrospective study. In all patients, the entero-enterostomy (EE) was closed using a double layered non-absorbable suture. In 2014, Peterson’s space was closed exclusively using glue, the years hereafter in a similar fashion as the EE, combined with a piece of glued BIO Mesh. Results The glued RYGB patients showed 25% of patients with an internal hernia (14%) or open Peterson’s space compared to 0.5% of patients (p < 0.001) who had a combined sutured and BIO Mesh Closure of their Peterson’s space defect. Although this was an ideal technique for Peterson’s space, it led to 1% of entero-enterostomy kinking due to the firm adhesion formation. Conclusion Gluing the intermesenteric spaces is not beneficial but placing a BIO Mesh in Peterson’s space is a promising new technique to induce local adhesions. It is above all safe, effective and led to an almost complete reduction of Peterson’s internal herniations. In the future, a randomized controlled trial comparing this technique to a double layered, non-absorbable suture should give more insights into which is the optimal closure technique. |
| first_indexed | 2024-12-20T07:25:51Z |
| format | Article |
| id | doaj.art-ba5bc2e4eafa428798295997caa2181f |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-20T07:25:51Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-ba5bc2e4eafa428798295997caa2181f2022-12-21T19:48:33ZengBMCBMC Surgery1471-24822021-05-012111610.1186/s12893-021-01197-0Preventing Peterson’s space hernia using a BIO synthetic meshAdam Skidmore0Edo O. Aarts1Department of General Surgery, Victorian Obesity Surgery Centre, Localized in Warringal Hospital and Knox Private HospitalWeightWorks Clinics, Surgical weight Loss ClinicAbstract Background Internal hernias occur after Roux-en-Y gastric bypass surgery (RYGB) when small bowel herniates into the intermesenteric spaces that have been created. The closure technique used is related to the internal hernia risks outcomes. Using a non-resorbable double layered suture, this risk can be significantly reduced from 8.9 to 2.5% in the first three postoperative years. By closing over a BIO mesh, the risk might be reduced even more. Setting Two large private hospitals specialized in bariatric surgery. Methods All patients receiving a RYGB for (morbid) obesity between 2014 and 2018 were included in this retrospective study. In all patients, the entero-enterostomy (EE) was closed using a double layered non-absorbable suture. In 2014, Peterson’s space was closed exclusively using glue, the years hereafter in a similar fashion as the EE, combined with a piece of glued BIO Mesh. Results The glued RYGB patients showed 25% of patients with an internal hernia (14%) or open Peterson’s space compared to 0.5% of patients (p < 0.001) who had a combined sutured and BIO Mesh Closure of their Peterson’s space defect. Although this was an ideal technique for Peterson’s space, it led to 1% of entero-enterostomy kinking due to the firm adhesion formation. Conclusion Gluing the intermesenteric spaces is not beneficial but placing a BIO Mesh in Peterson’s space is a promising new technique to induce local adhesions. It is above all safe, effective and led to an almost complete reduction of Peterson’s internal herniations. In the future, a randomized controlled trial comparing this technique to a double layered, non-absorbable suture should give more insights into which is the optimal closure technique.https://doi.org/10.1186/s12893-021-01197-0Roux-en-Y gastric bypassRYGBInternal herniaHerniaGlueBIO synthetic mesh |
| spellingShingle | Adam Skidmore Edo O. Aarts Preventing Peterson’s space hernia using a BIO synthetic mesh BMC Surgery Roux-en-Y gastric bypass RYGB Internal hernia Hernia Glue BIO synthetic mesh |
| title | Preventing Peterson’s space hernia using a BIO synthetic mesh |
| title_full | Preventing Peterson’s space hernia using a BIO synthetic mesh |
| title_fullStr | Preventing Peterson’s space hernia using a BIO synthetic mesh |
| title_full_unstemmed | Preventing Peterson’s space hernia using a BIO synthetic mesh |
| title_short | Preventing Peterson’s space hernia using a BIO synthetic mesh |
| title_sort | preventing peterson s space hernia using a bio synthetic mesh |
| topic | Roux-en-Y gastric bypass RYGB Internal hernia Hernia Glue BIO synthetic mesh |
| url | https://doi.org/10.1186/s12893-021-01197-0 |
| work_keys_str_mv | AT adamskidmore preventingpetersonsspaceherniausingabiosyntheticmesh AT edooaarts preventingpetersonsspaceherniausingabiosyntheticmesh |