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Preventing Peterson's space hernia using a BIO synthetic mesh
1Department of General Surgery, Victorian Obesity Surgery Centre, Localized in Warringal Hospital and Knox Private Hospital, 5 Burgundy Street, Heidelberg, Melbourne, VIC, 3084, Australia. adam@vosc.com.au.
BMC Surgery
|May 5, 2021
Summary
Internal hernias after Roux-en-Y gastric bypass (RYGB) can be reduced by using a BIO Mesh closure technique. This method significantly lowers the risk of internal hernias and open defects compared to traditional suturing or gluing methods.
Area of Science:
- Bariatric Surgery
- Surgical Techniques
- Hernia Prevention
Background:
- Internal hernias are a complication following Roux-en-Y gastric bypass (RYGB).
- The method used to close surgical defects influences internal hernia risk.
- Non-resorbable sutures reduce risk, but BIO Mesh may offer further improvement.
Purpose of the Study:
- To evaluate the efficacy of a BIO Mesh closure technique in preventing internal hernias after RYGB.
- To compare the outcomes of BIO Mesh closure with traditional suturing and glue methods for Peterson's space defects.
Main Methods:
- Retrospective study of RYGB patients from 2014-2018 at two specialized bariatric surgery hospitals.
- Entero-enterostomy (EE) closure used double-layered non-absorbable suture.
- Peterson's space closure initially used glue, later transitioned to glue with BIO Mesh.
Main Results:
- BIO Mesh closure of Peterson's space resulted in only 0.5% of patients with internal hernias or open defects, a significant reduction from 25% in the glued group.
- The BIO Mesh technique was safe and effective, almost eliminating Peterson's space internal hernias.
- A 1% rate of entero-enterostomy kinking was observed with the BIO Mesh technique due to adhesion formation.
Conclusions:
- Gluing intermesenteric spaces is not beneficial for preventing internal hernias.
- BIO Mesh placement in Peterson's space is a safe and effective technique for inducing local adhesions and reducing internal hernias.
- Further research via randomized controlled trials is recommended to compare BIO Mesh closure with double-layered non-absorbable sutures for optimal technique selection.
