Roux limb volvulus in laparoscopic Roux-en-Y gastric bypass due to Roux limb stabilization suture: case series

Area of Science:

• Bariatric Surgery
• Surgical Complications
• Gastrointestinal Surgery

Background:

• Complications following laparoscopic Roux-en-Y gastric bypass (LRYGB) may stem from surgical techniques.
• Roux limb stabilization sutures are intended to prevent kinking at the gastrojejunal anastomosis.
• This technique, however, has been associated with adverse events, including intestinal obstruction.

Purpose of the Study:

• To investigate intestinal obstruction caused by Roux limb stabilization sutures.
• To evaluate the incidence and outcomes of Roux limb volvulus secondary to this specific surgical stitch.

Main Methods:

• Retrospective review of prospectively collected data.
• Analysis of laparoscopic Roux-en-Y gastric bypass cases requiring reoperation for Roux limb volvulus.
• Comparison of outcomes before and after eliminating the stabilization suture.

Main Results:

• Four out of 199 patients (2.01%) developed Roux limb volvulus postoperatively.
• Volvulus was directly attributed to the stabilization suture in all cases.
• Eliminating the suture in 250 subsequent cases resulted in zero instances of Roux limb volvulus.

Conclusions:

• Roux limb stabilization sutures can lead to volvulus and subsequent intestinal obstruction.
• Avoiding the use of this specific suture is an effective method to prevent this complication.
• This finding suggests a modification in surgical technique to enhance patient safety in LRYGB.