BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (BGYRL) is one of the
most performed procedures worldwide, one of its complications is the internal hernia
(HI), presenting a significative and highly variable incidence in the literature (0-16%).
So, the objective of this study was to analyze the incidence of internal hernia after
BGYRL in a private hospital in the city of Belém, Pará. METHODS: Were revised the
records of the patients which were submitted to BGYRL between January/2011 and
December/2016 and developed HI in post-operatory diagnosed with laparoscopy.
The analytical statistics was utilized to evaluate the results of the categorical
variables on the sample through the G test and Pearson’s chi-square test RESULTS:
180 pacients (117 women and 63 men) were submitted to BGYRL at the studied
hospital in the stablished period, 16,7% were diagnosed with HI (n=30),
demonstrating a higher incidence than was found in the literature. Being 18 females
(60%) and 12 males (40%), it wasn’t found statistical significance in the proportion
between the sexes (p=0.3613). About the age groups of the patients diagnosed with
HI, from 20 to 30 years presented 3 cases (33,3%); 31 to 40 years presented 12
cases (40%); 41 to 50 years presented 10 cases (33,3%); 51 to 60 years presented 5
cases (16,7%). There were no meaningful difference between the age groups (p =
0.0635). The principal site of intestinal herniation found during laparoscopy in
patients diagnosed with HI was through Petersen’s space (n=20; 66,7%), there were
statistical significance in these group (p=0.0004). Laparoscopy was diagnostic as it
was resolutive in 28 patients with HI (p < 0.0001). 29 patients were discharged from
hospital (96,67%) and 1 died during hospital internment (3,33%). CONCLUSION:
The incidence of HI in patients submitted to BGYRL in the referred hospital is higher
than found in the literature. In the majority of the cases the correction of HI was made
with success through laparoscopy. There is no consensus in the literature about
which would be the principal site of internal herniation. The demographics were not
statistically relevant in relation to HI. The conversion rate to laparotomy and the
necessity of reoperations practically were not debated in the publicated researches,
being necessary more detailed studies to evaluate the importance of these factors in
the morbimortality of this pathology. There are few studies about this complication,
which is possibly fatal; therefore more researches are necessary, mainly due to the
growing number of bariatric surgeries in the last years.
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