Internal Hernias After Laparoscopic Gastric Bypass

NCT01040364 | Completed DMC

• 2 other identifiers: CMC IRB No. 2009024U1111-1113-0414
• Study Type: observational
• Target: 220
• Locations: 1 country
• Sites: 1

Brief Summary

The main goal of this study is to describe the trends in the incidence rate of internal hernia presentation after different modifications of the mesenteric closure technique after primary laparoscopic Roux-en-Y gastric bypass (RYGB) surgery from 1997-2009.

Conditions

Internal Hernia; Mesocolic Hernia; Petersen´s Hernia; Jejunojejunostomy Hernia; Bowel Obstruction; Ischemic Bowel

Keywords

Internal hernia; Mesocolic hernia; Petersen´s hernia; Jejunojejunostomy hernia; Bowel obstruction; Ischemic bowel; Complication after gastric bypass; Re-operative bariatric surgery; Chronic pain after gastric bypass

Outcome Measures

Primary Outcomes (2)

• Closure technique for mesocolic defect: 1- non-closure, 2- running with absorbable material, 3- interrupted with non-absorbable material, and 4- running with non-absorbable

  throughout follow-up

• recurrence of symptomatic mesocolic internal hernia

  throughout follow-up

Study Arms (1)

Interna hernia after primary gastric bypass

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients presenting with internal hernia after different modifications of the mesenteric closure technique after Primary Laparoscopic RYGB surgery from 1997-2009.

You may qualify if:

• patient status post primary laparoscopic standard RYGB surgery who underwent internal hernia reduction and repair with any or the combination of the following:
• closure of synchronous mesocolic or mesenteric space defects without incarcerated bowel
• conversion to open (laparotomy)
• small bowel resection with or without reversal
• status post primary laparoscopic standard RYGB surgery with incidental finding of internal hernia space defect with or without bowel through the defect

You may not qualify if:

• any other type of re-operative surgery after primary standard RYGB
• patient age \< 18 years
• missing records and/or unreachable patients with scant information for analysis

Sponsors & Collaborators

• University of California, San Francisco: lead

Study Sites (1)

UCSF Fresno Center for Medical Education and Research, Department of Surgery

Fresno, California, 93701, United States

Location

Related Publications (26)

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• Sjostrom L, Narbro K, Sjostrom CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B, Bengtsson C, Dahlgren S, Gummesson A, Jacobson P, Karlsson J, Lindroos AK, Lonroth H, Naslund I, Olbers T, Stenlof K, Torgerson J, Agren G, Carlsson LM; Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007 Aug 23;357(8):741-52. doi: 10.1056/NEJMoa066254.

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  PMID: 17895461 BACKGROUND

• Meguid MM, Glade MJ, Middleton FA. Weight regain after Roux-en-Y: a significant 20% complication related to PYY. Nutrition. 2008 Sep;24(9):832-42. doi: 10.1016/j.nut.2008.06.027.

  PMID: 18725080 BACKGROUND

• Nguyen NT. Reoperations and revisions in bariatric surgery. Surg Endosc. 2007 Nov;21(11):1907-8. doi: 10.1007/s00464-007-9572-6. Epub 2007 Sep 8. No abstract available.

  PMID: 17828427 BACKGROUND

• http://www.asbs.org/htm/Private/resolution.html. American Society of Metabolic and Bariatric Surgeons.

  BACKGROUND

• Capella RF, Iannace VA, Capella JF. Bowel obstruction after open and laparoscopic gastric bypass surgery for morbid obesity. J Am Coll Surg. 2006 Sep;203(3):328-35. doi: 10.1016/j.jamcollsurg.2006.05.301. Epub 2006 Jul 27.

  PMID: 16931305 BACKGROUND

• Champion JK, Williams M. Small bowel obstruction and internal hernias after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2003 Aug;13(4):596-600. doi: 10.1381/096089203322190808.

  PMID: 12935361 BACKGROUND

• Felsher J, Brodsky J, Brody F. Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Surgery. 2003 Sep;134(3):501-5. doi: 10.1067/s0039-6060(03)00251-4.

  PMID: 14555940 BACKGROUND

• Hwang RF, Swartz DE, Felix EL. Causes of small bowel obstruction after laparoscopic gastric bypass. Surg Endosc. 2004 Nov;18(11):1631-5. doi: 10.1007/s00464-004-8804-2. Epub 2004 Oct 11.

  PMID: 15931476 BACKGROUND

• Carmody B, DeMaria EJ, Jamal M, Johnson J, Carbonell A, Kellum J, Maher J. Internal hernia after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2005 Nov-Dec;1(6):543-8. doi: 10.1016/j.soard.2005.08.005. Epub 2005 Sep 28.

  PMID: 16925288 BACKGROUND

• Cho M, Pinto D, Carrodeguas L, Lascano C, Soto F, Whipple O, Simpfendorfer C, Gonzalvo JP, Zundel N, Szomstein S, Rosenthal RJ. Frequency and management of internal hernias after laparoscopic antecolic antegastric Roux-en-Y gastric bypass without division of the small bowel mesentery or closure of mesenteric defects: review of 1400 consecutive cases. Surg Obes Relat Dis. 2006 Mar-Apr;2(2):87-91. doi: 10.1016/j.soard.2005.11.004. Epub 2006 Mar 3.

  PMID: 16925328 BACKGROUND

• DeMaria EJ, Sugerman HJ, Kellum JM, Meador JG, Wolfe LG. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002 May;235(5):640-5; discussion 645-7. doi: 10.1097/00000658-200205000-00005.

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• Dresel A, Kuhn JA, Westmoreland MV, Talaasen LJ, McCarty TM. Establishing a laparoscopic gastric bypass program. Am J Surg. 2002 Dec;184(6):617-20; discussion 620. doi: 10.1016/s0002-9610(02)01098-x.

  PMID: 12488190 BACKGROUND

• Eckhauser A, Torquati A, Youssef Y, Kaiser JL, Richards WO. Internal hernia: postoperative complication of roux-en-Y gastric bypass surgery. Am Surg. 2006 Jul;72(7):581-4; discussion 584-5.

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• Filip JE, Mattar SG, Bowers SP, Smith CD. Internal hernia formation after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Am Surg. 2002 Jul;68(7):640-3.

  PMID: 12132750 BACKGROUND

• Garza E Jr, Kuhn J, Arnold D, Nicholson W, Reddy S, McCarty T. Internal hernias after laparoscopic Roux-en-Y gastric bypass. Am J Surg. 2004 Dec;188(6):796-800. doi: 10.1016/j.amjsurg.2004.08.049.

  PMID: 15619502 BACKGROUND

• Gould JC, Garren MJ, Boll V, Starling JR. Laparoscopic gastric bypass: risks vs. benefits up to two years following surgery in super-super obese patients. Surgery. 2006 Oct;140(4):524-9; discussion 529-31. doi: 10.1016/j.surg.2006.07.002.

  PMID: 17011899 BACKGROUND

• Higa KD, Ho T, Boone KB. Internal hernias after laparoscopic Roux-en-Y gastric bypass: incidence, treatment and prevention. Obes Surg. 2003 Jun;13(3):350-4. doi: 10.1381/096089203765887642.

  PMID: 12841892 BACKGROUND

• Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004 Jun 16;291(23):2847-50. doi: 10.1001/jama.291.23.2847.

  PMID: 15199035 BACKGROUND

Related Links

• "Click here for more information about the department sponsor´s web site"

MeSH Terms

Conditions

Internal Hernia; Intestinal Obstruction

Condition Hierarchy (Ancestors)

Hernia; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms; Intestinal Diseases; Gastrointestinal Diseases; Digestive System Diseases

Study Officials

• Francisco M Tercero, MD

  Research Associate, University of California San Francisco

  STUDY DIRECTOR

• Kelvin D Higa, MD

  Professor of Surgery, University of California San Francisco

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 26, 2009
• First Posted: December 29, 2009
• Study Start: May 1, 2009
• Primary Completion: June 1, 2009
• Study Completion: July 1, 2009
• Last Updated: September 24, 2013

Record last verified: 2013-09

Locations

US (1)