Ischemic bowel after laparoscopic Roux-en-Y gastric bypass: limited resection based on fluorescein assessment of bowel viability

Abstract

Small bowel obstruction (SBO) occurs in 1.5–4% of patients after laparoscopic Roux-en-Y gastric bypass (LRYGB) [1–5] and results from internal hernia in 30–50% of cases [1, 6]. Three potential internal hernia defects result from RYGB: the jejunojejunostomy mesenteric defect, Petersen’s defect, and the transverse mesocolon defect [2]. Routine closure of all three defects with continuous nonabsorbable suture has been advocated [7].