Endoscopic Hernia Multifeed Stapler (EHMS)
Closure of Mesenteric Defects in
Laparoscopic Roux-en-Y Gastric Bypass
in order to Prevent Internal Hernias
Small bowel obstruction due to internal hernia is the most common and potentially serious complication after laparoscopic Roux-en-Y gastric bypass [1,2,6,7].
Complete closure of mesenteric defects in laparoscopic Roux-en-Y gastric bypass results in a significant reduction in internal mesenteric hernias [3,5,7].
The reported risk of complication caused by closure of the mesenteric defects is low [4,7]. Primary closure of mesenteric defects can be performed safely and should be viewed as a routine part of that operation [2,7].
- Vague colic pain
- Mostly pain in left abdomen
- Intermittant character
Incidence of internal hernia :
- Non-closure: 11,7%
- Closure: 2,5%
On average a bariatric or metabolic surgeon will require 14-16 staples of the EHMS to close both mesenteric defects with a double-layer. Given the fact that the EHMS is preloaded with 20 titanium staples enables the bariatric or metabolic surgeon to close both defects without any instrument exchange and/or disruption of the surgical flow.