Internal Hernia After Laparoscopic One-Anastomosis (Mini) Gastric Bypass: Video Case Series of a Single-Center Experience.

Internal hernia (IH) after one-anastomosis gastric bypass (OAGB) was thought to have an extremely low incidence. In this video, we report three cases of post-OAGB symptomatic internal herniation. The first case is a 45-year-old female who presented 4 months after her OAGB with crampy abdominal pain and reflux symptoms. An exploratory laparoscopy showed Petersen's hernia; the hernia was reduced with no ischemia and the defect was closed. The second case is a 40-year-old male who presented 7 months after his surgery with abdominal pain and reflux. An exploratory laparoscopy showed Petersen's hernia; bowel was reduced and defect was closed through a laparotomy. The third case is a 64-year-old male who presented with refractory biliary reflux after OAGB. An elective diagnostic laparoscopy showed Petersen's hernia; the hernia was reduced and defect was closed. All patients recovered well with no recurrence of symptoms on follow-up. Internal hernia after OAGB is more common than the reported incidence. The threshold for diagnostic laparoscopy should be lowered for a OAGB patient with symptoms suggestive of IH.

Chylous Ascites Post Laparoscopic Sleeve Gastrectomy: Video Case Report of a Rare Complication.

We report a 38-year-old morbidly obese female patient, who presented 10 days post sleeve gastrectomy with chylous ascites. A lymphangiogram showed free leakage from a small tributary of the cisterna chyli. Conservative measures failed to control the leak. The patient was taken for surgery. Laparoscopic exploration with intralipid injection through an orogastric tube revealed the leaking area near the hiatal surface posterior to the stomach and it was ligated with non-absorbable sutures and wrapped with a thrombin patch. The patient was discharged home in a good condition. Patient was followed up in the clinic after 2 weeks, 6 weeks, and 3 months with no complaint.