Reduced Incidence of Internal Hernia with Meticulous Mesenteric Defect Closure in Gastric Bypass

Meticulous closure of mesenteric defects during laparoscopic Roux-en-Y gastric bypass significantly reduces the risk of internal hernia, particularly at the jejunojejunostomy and Petersen defects. Improvements in closure techniques led to a notable decrease in internal hernia incidence over time, with the most effective method involving non-absorbable sutures and an additional purse-string suture. Clinicians should maintain a high level of suspicion for internal hernia in post-operative patients experiencing acute abdominal pain.