Abstract
BackgroundTo observe if closing the mesenteric defect with absorbable sutures creates a safe adhesion compared to non-absorbable suture after Roux-en-Y gastric bypass.MethodsRats were randomly assigned to 5 experimental groups according to the different suture materials used in closing the mesenteric defects (Peterson’s space) after Roux-en-Y gastric bypass. Group A (control group), Group B (non-absorbable suture, Prolene suture), Group C (biological glue), Group D (non-absorbable suture, polyester suture) and Group E (absorbable suture). All rats were followed up for 8 weeks postoperatively and underwent laparotomy to observe the degree of adhesion and closure of the mesenteric defect.ResultsNo significant difference was found in the decrease in food intake and body weight among all groups. No internal hernia (IH) occurred in any group. The mesenteric defects of Group A remained completely visible without any closure or adhesion. Multiple gaps were found between the Prolene suture and the mesentery along the suture line in Group B. The mesenteric defects of Group C were complete closed with multiple adhesions of the small intestine and the greater omentum. The mesenteric defects in both Group D and Group E closed completely. The average adhesion scores in Group A and Group B were 0 and 0.33 ± 0.52 respectively. The average adhesion score in group C (3.83 ± 0.41) was higher than the other groups (p<0.05). The average adhesion scores in Group D and E were similar (3.17 ± 0.41 and 3.00 ± 0.00 respectively).ConclusionAbsorbable suture created a safe adhesion score between the mesentery which was not inferior to non-absorbable sutures.
Highlights
To observe if closing the mesenteric defect with absorbable sutures creates a safe adhesion compared to non-absorbable suture after Roux-en-Y gastric bypass
Internal hernia (IH), which leads to small bowel obstruction (SBO) is an important long-term clinical complication after Roux-en-Y Gastric Bypass (RYGB) surgery
We believed that absorbable sutures are safe and not inferior to non-absorbable suture to close mesenteric defect
Summary
To observe if closing the mesenteric defect with absorbable sutures creates a safe adhesion compared to non-absorbable suture after Roux-en-Y gastric bypass. Internal hernia (IH), which leads to small bowel obstruction (SBO) is an important long-term clinical complication after Roux-en-Y Gastric Bypass (RYGB) surgery. It can occur many years after the primary surgery or throughout life with serious consequences; often requiring extensive intestinal resection. A study by Stenber g et al [10], suggested that closure of the mesenteric defects could potentially increase the risk of early small bowel obstruction caused by kinking of the jejunojejunostomy. Most studies still (2020) 20:8 suggests that routine closure of mesenteric defect could reduce the risk of IH
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