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Comment on: The impact of routine division of the greater omentum on small bowel obstruction after Roux-en-Y gastric bypass

Published:October 10, 2022DOI:https://doi.org/10.1016/j.soard.2022.10.009
      Roux-en-Y gastric bypass (RYGB) is an effective treatment for obesity with low complication rates. The risks of anastomotic leak, marginal ulcer, and small bowel obstruction (SBO) mainly due to internal hernia remain a challenge. There are techniques to mitigate these risks, including utilizing an antecolic antegastric approach and closure of the mesenteric defects. These technical steps have been shown to reduce the risk of internal hernias both in retrospective studies and randomized controlled trials [
      • Magouliotis D.E.
      • Tzovaras G.
      • Tasiopoulou V.S.
      • Christodoulidis G.
      • Zacharoulis D.
      Closure of mesenteric defects in laparoscopic gastric bypass: a meta-analysis.
      ,
      • Stenberg E.
      • Szabo E.
      • Ågren G.
      • et al.
      Closure of mesenteric defects in laparoscopic gastric bypass: a multicentre, randomised, parallel, open-label trial.
      ]. The authors of this article certainly subscribe to this dictum and have previously contributed to our understanding of the importance of mesenteric closures.
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      References

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        • Zacharoulis D.
        Closure of mesenteric defects in laparoscopic gastric bypass: a meta-analysis.
        Obes Surg. 2020; 30: 1935-1943
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        The impact of routine division of the greater omentum on small bowel obstruction after Roux-en-Y gastric bypass.
        Surg Obes Relat Dis. Epub 2022 Sep 12; https://doi.org/10.1016/j.soard.2022.09.006
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        Does the non-absorbable suture closure of the jejunal mesenteric defect reduce the incidence and severity of internal hernias after laparoscopic Roux-en-Y gastric bypass?.
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        Omental torsion after laparoscopic Roux-en-Y gastric bypass mimicking appendicitis: a case report and review of the literature.
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