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Gastric bypass with unknown intestinal malrotation: Required attitude.

Kassir R, Blanc P, Varlet F, Breton C, Lointier P - Int J Surg Case Rep (2013)

Bottom Line: The result in weight loss was perfect and identical to that of patients without anatomical abnormality.Bariatric surgeons need to be aware of these abnormalities.If a common mesentery is present the gastric bypass can still be performed.

View Article: PubMed Central - PubMed

Affiliation: Department of Digestive Surgery, Clinique Chirurgicale Mutualiste, Saint Etienne, France. Electronic address: radwankassir42@hotmail.Fr.

No MeSH data available.


Related in: MedlinePlus

Connection in which peristalsis does not occurs in a single direction.
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fig0030: Connection in which peristalsis does not occurs in a single direction.

Mentions: If a common mesentery is present, the gastric bypass is performed in the same way although the biliary-pancreatic loop comes from the patient's right (on the left on the screen) and the alimentary loop comes from the patient's left (on the right of the screen) (Fig. 5). If the angle of the Treitz ligament is not pinpointed accurately, as is always necessary, there is a risk of creating an antiperistaltic anastomosis (Fig. 6). With this anatomy, the position generally needs to be changed or trocars need to be added. It appears to us that Roux en Y gastric bypass is easier to perform if a rotation abnormality is discovered incidentally. The operation strategy can also be changed, either by not performing the intended procedure or by performing a sleeve gastrectomy. In these situations the patient must be informed of the possibility that this may occur pre-operatively. We inform patients of this as a matter of routine for all gastric bypasses. No intestinal or mesenteric pexy procedures have been proved to be useful or even safe and the bowel should be left as it is without fixation.10


Gastric bypass with unknown intestinal malrotation: Required attitude.

Kassir R, Blanc P, Varlet F, Breton C, Lointier P - Int J Surg Case Rep (2013)

Connection in which peristalsis does not occurs in a single direction.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860040&req=5

fig0030: Connection in which peristalsis does not occurs in a single direction.
Mentions: If a common mesentery is present, the gastric bypass is performed in the same way although the biliary-pancreatic loop comes from the patient's right (on the left on the screen) and the alimentary loop comes from the patient's left (on the right of the screen) (Fig. 5). If the angle of the Treitz ligament is not pinpointed accurately, as is always necessary, there is a risk of creating an antiperistaltic anastomosis (Fig. 6). With this anatomy, the position generally needs to be changed or trocars need to be added. It appears to us that Roux en Y gastric bypass is easier to perform if a rotation abnormality is discovered incidentally. The operation strategy can also be changed, either by not performing the intended procedure or by performing a sleeve gastrectomy. In these situations the patient must be informed of the possibility that this may occur pre-operatively. We inform patients of this as a matter of routine for all gastric bypasses. No intestinal or mesenteric pexy procedures have been proved to be useful or even safe and the bowel should be left as it is without fixation.10

Bottom Line: The result in weight loss was perfect and identical to that of patients without anatomical abnormality.Bariatric surgeons need to be aware of these abnormalities.If a common mesentery is present the gastric bypass can still be performed.

View Article: PubMed Central - PubMed

Affiliation: Department of Digestive Surgery, Clinique Chirurgicale Mutualiste, Saint Etienne, France. Electronic address: radwankassir42@hotmail.Fr.

No MeSH data available.


Related in: MedlinePlus