An unusual case of early small bowel obstruction after Roux-en-Y gastric bypass by the free end of a V-loc™ suture.

Abstract

Weight recurrence and gastro-esophageal reflux disease are the most common causes for re-operation after sleeve gastrectomy (SG); Roux-en-Y gastric bypass is the recommended procedure to correct both problems. The V-loc™ (Covidien, Dublin, Ireland) enables faster suturing and less operative time compared to non-barbed sutures. We report an unusual case of early obstruction at the jejunojejunostomy by the tail of V-loc™ suture which grasped surrounding tissue causing adhesions and subsequent obstruction. When reviewing the literature for complications of V-loc™, we found three cases of bowel obstruction caused by the leftover free segment of V-loc™. So, V-loc™ thread can cause small bowel obstruction; therefore, we recommend not leaving an extra length at its free end and keep it to a minimum length possible.