Incidence of Intestinal Obstruction Secondary to Petersen's Hernia after Laparoscopic Roux-en-Y Gastric Bypass
Authors:   Head of department of bariatric and metabolic surgery in the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Salvador Quevedo y Zubieta 750, Independencia Oriente, 44340, Guadalajara, Jalisco, Mexico., Sánchez-Muñoz PhD Martha Patricia , Mendoza, MD. Carlos Manuel Moreno- ,   Department of bariatric and metabolic surgery in the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Salvador Quevedo y Zubieta 750, Independencia Oriente, 44340, Guadalajara, Jalisco, Mexico., Aldana-Aguiñaga, PhD Ma. Soledad ,   Department of bariatric and metabolic surgery in the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Salvador Quevedo y Zubieta 750, Independencia Oriente, 44340, Guadalajara, Jalisco, Mexico, Cerda-Trujillo PhD. Liliana Faviola De la ,   Department of General Surgery in the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Salvador Quevedo y Zubieta 750, Independencia Oriente, 44340, Guadalajara, Jalisco, Mexico., Ramirez-Plascencia MD. Lilia Esther ,   Department of Anesthesiology in the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Salvador Quevedo y Zubieta 750, Independencia Oriente, 44340, Guadalajara, Jalisco, Mexico., Martínez-Rodríguez, MD. Eduardo Luis ,   Department of bariatric and metabolic surgery in the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Salvador Quevedo y Zubieta 750, Independencia Oriente, 44340, Guadalajara, Jalisco, Mexico., Alvarez-Ortiz, MD. José Antonio ,   Department of bariatric and metabolic surgery in the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Salvador Quevedo y Zubieta 750, Independencia Oriente, 44340, Guadalajara, Jalisco, Mexico., Roque-Marchena, MD. Alejandro Antonio ,   Department of bariatric and metabolic surgery in the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Salvador Quevedo y Zubieta 750, Independencia Oriente, 44340, Guadalajara, Jalisco, Mexico., Camba-Gutierrez, MD. Ileana Susana ,   Department of bariatric and metabolic surgery in the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Salvador Quevedo y Zubieta 750, Independencia Oriente, 44340, Guadalajara, Jalisco, Mexico., Valencia-Gómez, MD. Alberto ,   Department of bariatric and metabolic surgery in the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Salvador Quevedo y Zubieta 750, Independencia Oriente, 44340, Guadalajara, Jalisco, Mexico., Ortíz-Orozco MD. César Alberto ,   Department of General Surgery in the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”. Salvador Quevedo y Zubieta 750, Independencia Oriente, 44340, Guadalajara, Jalisco, Mexico.
Published: January 2023

Objective: Identify the incidence of Petersen's hernia in gastric bypass patients at our institution. Summary: Laparoscopic gastric bypass has proved to be the best treatment for obesity and the resolution of their complications, however, it presents long-term complications such as Petersen's hernia. Methods: A retrospective study of a single center, with a total of 225 gastric bypass performed in the bariatric and metabolic surgery clinic of the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca” from January 2014 to March 2020. Results: Of the 225 operated patients, a global follow-up of 80.44% was obtained, with an average postoperative follow-up of 31 (+/-20.92) months, it was found that in 10 patients (4.44%) presented a symptomatic internal hernia. Of these, 9 patients was admitted to the emergency room and 1 detected in the outpatient clinic. These patients presented at the time of surgery a BMI of 27.65 (+/- 5.01) with a percentage of excess weight lost of 62.35% (+/- 25.60). The laparoscopic approach could be completed in 100% of the cases. Regarding hospital stay, an average of 1.1 (+/- 0.31) days was presented. No trans-surgical complications or mortality were reported in the group studied. The mean time between primary surgery and reoperation was 21.3 (+/- 12.98) months. Conclusion: In a 6-year period with a global follow-up of 80.44%, where the Petersen defect was not closed. An incidence of 4.44% was found, with an average follow-up of 31 (+/- 20.92) months. However, the percentage of Petersen's hernia may be underestimated since only those with symptoms that lead the patient to emergency care are usually diagnosed, so a high index of suspicion must always be had.