Novel Technique in Closure of Mesenteric Defects After Laparoscopic Roux-en-Y Gastric Bypass and Its Effect on Internal Hernia: a Case-control Study

Study Overview
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Brief Summary
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This study is to investigate the rate of internal hernia after laparoscopic Rox-en-Y gastric bypass when the defects are closed using cyano-acrylate glue.

Detailed Description
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Background Internal hernia complicated by bowel obstruction is a well-recognized complication of laparoscopic Roux-en-Y gastric bypass (LRYGB). The present study aims to investigate the role of cyanoacrylate glue in the prevention of internal hernia (IH) after LRYGB and compare it with the open technique of managing mesenteric defects by leaving the mesentery intact without closure of mesenteric defects. Data from six UK hospitals have been involved in this study. Operations were done under the supervision of a single senior consultant surgeon of bariatric surgery. Methods The prospectively collected data of 813 patients with morbid obesity who underwent LRYGB were retrospectively analyzed. Patients were subdivided into two groups: group I comprising 185 patients who had the mesenteric defects closed with cyanoacrylate glue and group II comprising 628 patients who were managed by the open technique of leaving the mesentery intact without closure of the mesenteric defects.

Official Title
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Analytical Study of Internal Hernia Following Laparoscopic Roux-eny Gastric Bypass

Conditions
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Bariatric Surgery

Intervention / Treatment
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* Other: Closure of mesenteric defects using glue


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients who underwent antecolic LRYGB without closure of mesenteric defects using cyanoacrylate glue or without closure of the mesenteric defects. Exclusion Criteria: Open RYGB, laparoscopic converted to open RYGB, laparoscopic retro-colic RYGB, laparoscopic ante-colic RYGB with closure of the defect using sutures or RYGB done for non-bariatric purposes e.g. idiopathic gastroparesis.
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Non-closure group<br>Group in which mesenteric defects were not closed after laparoscopic Roux-en-Y gastric bypass. | |
| Closure group<br>Group in which mesenteric defects were closed using cyano-acrylate glue after laparoscopic Roux-en-Y gastric bypass. | Other: Closure of mesenteric defects using glue<br>* Cyano-acrylate glue is a glue known to be used in surgery as tissue adhesive.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants with internal hernia after Laparoscopic Roux-en-Y gastric bypass |  | September 2007 to January 2020 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Bypass, Gastric; Obesity, Morbid; Glue. Internal hernia; Laparoscopy.