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Laparoscopic repair of internal hernia during pregnancy after Roux-en-Y gastric bypass
Laparoscopic Roux-en-Y gastric bypass as a treatment of severe obesity has increased dramatically in the past decade, and most of the patients have been women [1,2]. The health risks experienced by obese women during pregnancy can be reduced by the weight loss induced by bariatric surgery [3–5], but these patients are at risk of bariatric surgical complications during their pregnancies. Women who have undergone Roux-en-Y gastric bypass for morbid obesity are at risk of internal hernias, intussusception, and small bowel obstruction during pregnancy, which can lead to maternal and/or fetal death [6].Laparoscopic reduction of small bowel intussusception in a 33-week pregnant gastric bypass patient: surgical technique and review of literature
Intussusception is a rare etiology of bowel obstruction in adults and accounts for 1–3% of those cases. It is associated with an underlying mass such as a tumor or polyp in >80% of patients [1–4]. In gastric bypass patients, intussusception is an uncommon complication [5,6]. The common channel distal to the jejunojejunostomy is the usual site of intussusceptions. The direction of intussusception can be either antegrade or retrograde, but most reported cases are retrograde in nature. The probable etiology can include the presence of an ectopic pacemaker causing retrograde peristalsis.
