Published online Aug 27, 2020. doi: 10.4240/wjgs.v12.i8.346
Peer-review started: May 2, 2020
First decision: May 24, 2020
Revised: May 31, 2020
Accepted: July 26, 2020
Article in press: July 26, 2020
Published online: August 27, 2020
Roux-en-Y reconstruction has been one of the standard options after laparoscopic distal gastrectomy. Its complications include Petersen’s hernia and Roux stasis syndrome. Although Petersen’s hernia is a rare complication, it is difficult to diagnose and cause serious postoperative complications. Meanwhile, Roux stasis syndrome is widely reported and reduces the post-operative nutritional status of patients.
Many improved methods were invented for decreasing the incidence of Petersen’s hernia and Roux stasis syndrome, however, some of them are technically complex elements and time-consuming. We developed an easy and effective method to narrow the Petersen’s defect and reduce the development of Roux stasis syndrome using surgical techniques.
The primary objective of the study was to develop an easy and effective method to decrease the development of Petersen’s hernia and Roux stasis syndrome.
We fixed Roux limb onto the duodenal stump in a smooth radian after Roux-en-Y reconstruction. Via this small improvement in Roux limb, Roux limb was placed to the right of the ligament of Treitz. This not only changed the anatomy of the Petersen’s defect, but it also kept a fluent direction of gastrointestinal retrospective analysis review of the data of 31 consecutive patients who was performed this technique between July 2015 and March 2017.
This improvement method took about 10 min. All patients were followed up for at least 3 year, and none of the patients developed postoperative complications related to internal hernia or Roux stasis syndrome.
This 10 min technique is a very effective method to decrease the development of Petersen’s hernia and Roux stasis syndrome in patients who undergo laparoscopic distal gastrectomy
In this study, we report a case series of a simple and effective method for decreasing the development of Petersen’s hernia and Roux stasis syndrome. Because of the length of follow up, our study did not provide enough data to show conclusions about long-term outcomes. We will continue to perform this technique and collect more data to prove the long-term effect of this technique.