Preventing Peterson’s space Hernia Using a Bio Synthetic Mesh

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Adam Peter Skidmore, Edo O Aarts

Abstract

Introduction 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...Continue Reading

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