A paradoxical internal hernia at Brolin's anti-obstruction stitch following Roux-en-Y gastric bypass: a case report.

Internal hernias are a rare but morbid complication following Roux-en-Y gastric bypass surgery. The incorporation of Brolin's anti-obstruction stitch has historically demonstrated a significant reduction in the incidence of internal hernias following Roux-en-Y gastric bypass. We present an ironic and unique case of a patient with small bowel herniation into a defect between Brolin's stitch and the stapled closed common enterotomy of the jejunojejunostomy and technical considerations to decrease internal hernias at this site in the future.

Operative technique for a successful laparoscopic en-bloc resection of gastrogastric fistula following roux-en-Y gastric bypass.

Gastrogastric fistulas are rare complications following Roux-en-Y gastric bypass surgery and are characterized by a fistulous connection between the gastric pouch and the remnant stomach. The presentation is often variable and a high-index of suspicion must be maintained for accurate and timely diagnosis. In this case report, we provide a detailed review of the technical steps taken to successfully resect a gastrogastric fistula en-bloc laparoscopically with an unremarkable post-operative course.

The 15-cm Roux Limb: a Technical Misadventure.

Background: Despite effectively treating obesity and its comorbidities, only a fraction of the growing obese population is evaluated for bariatric surgery. Aside from barriers including resources and social support, patients report personal experience with friends and relatives suffering poor outcomes after bariatric surgery. Rates of mortality, leaks, and strictures have decreased over the past 20 years, but few instances of gross surgeon error have been reported in the literature.

Endoscopic closure of colon perforation compared to surgery in a porcine model: a randomized controlled trial (with videos).

Background: Endoscopic closure of inadvertent or intentional colon perforations might be valuable if comparable to surgical closure.

Objective: The aim of this study was to compare endoscopic closure of a 4-cm colon perforation in a porcine model with surgical closure in a multicenter study.

Setting: University hospitals in the United States and Europe.

Emotional eating and emotional eating alternatives in subjects undergoing bariatric surgery.

Background: The purpose of this study was to characterize emotional eating and its alternatives in obese patients undergoing bariatric surgery.

Methods: The medical charts of 178 consecutive patients who had laparoscopic Roux-en-Y gastric bypass provided by a multidisciplinary bariatric program were reviewed. Data from patients who had emotional eating, reported strategies to overcome their urges to emotionally eat, and had their 6 months follow-up after surgery (N=50) were further analyzed in terms of weight history, medical co-morbidity prior to surgery, weight loss after surgery, and lifetime psychiatric status.