• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / LAPAROSCOPIC EXPLORATION FOR INTERNAL HERNIAS IS BEST PRACTICE DURING ANY RETURN TO OR AFTER LAPAROSCOPIC GASTRIC BYPASS

LAPAROSCOPIC EXPLORATION FOR INTERNAL HERNIAS IS BEST PRACTICE DURING ANY RETURN TO OR AFTER LAPAROSCOPIC GASTRIC BYPASS

Ransford Commey, MD, Ryan Lehmann, DO, FACS, FASMBS, Norbert Richardson, MD, FACS, FASMBS. St Alexius Hospital

Background:  Following laparoscopic gastric bypass, internal hernia can occur at Petersen’s space and at the jejunojejunostomy mesenteric defect, which can lead to potentially serious complications, and as such, must be promptly diagnosed and treated.  Port site hernia is a long term complication of laparoscopy.  The risk factors for hernia formation include age, wound infection, smoking, trocar site, trocar size and obesity.  Port site hernia is increased with incisions greater than 10mm in diameter.  In the RYGB with circular stapled gastrojejunostomy, the left lower quadrant port site is at greatest risk for hernia since it is dilated to accommodate the anvil and circular stapler.  

Methods:  We present the case of a 54-year-old obese female with a body mass index of 36.8 who is status post Lap-band revision to laparoscopic Roux-en-Y divided gastric bypass who presented with complaints of one week of epigastric pain radiating to the left upper quadrant.  She underwent a contrast computed tomography scan which showed a less than 1 cm bowel-containing ventral/incisional hernia.  She was subsequently taken to the operating room for laparoscopic exploration with planned open repair of the hernia.  On exploration, she was additionally found to have an internal hernia with strangulated small bowel at Petersen’s space which was reduced and repaired.  The incisional hernia, which appeared to be intramuscular, was also repaired in an open fashion using mesh.  

Results:  The video shows the evaluation of the port site hernia, beginning with laparoscopic exploration with reduction and repair of the incidentally found strangulated internal hernia at Petersen’s space.  The incisional hernia was then repaired in an open fashion.

Conclusion:  Laparoscopic Exploration for Internal Hernias is the best practice during any return to OR for abdominal pain after laparoscopic gastric bypass.  A missed diagnosis of internal hernia may cause potentially serious complications resulting from acute strangulation of the intestine.

 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87137

Program Number: V194

Presentation Session: Wednesday Video Loop (Non CME)

Presentation Type: VideoLoop

157

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals