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Background: Petersen's hernia, which occurs after Billroth-II (B-II) or Roux-en-Y (REY) anastomosis, can be reduced by defect closure. This study aims to compare the incidence of bowel obstruction above Clavien-Dindo classification grade III due to Petersen's hernia between the mesenteric fixation method and the conventional methods after laparoscopic or robotic gastrectomy.
Methods: This study was designed as prospective, single-blind, non-inferiority randomized controlled multicenter trial in Korea. Patients with histologically diagnosed gastric cancer of clinical stages I, II, or III who underwent B-II or REY anastomosis after laparoscopic or robotic gastrectomy are enrolled in this study. Participants who meet the inclusion criteria are randomly assigned to two groups: a CLOSURE group that underwent conventional Petersen's defect closure method and a MEFIX group that underwent the mesenteric fixation method. The primary endpoint is the number of patients who underwent surgery for bowel obstruction caused by Petersen's hernia within 3 years after laparoscopic or robotic gastrectomy.
Discussion: This trial is expected to provide high-level evidence showing that the MEFIX method can quickly and easily close Petersen's defect without increased postoperative complications compared to the conventional method.
Trial Registration: ClinicalTrials.gov NCT05105360. Registered on November 3, 2021.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10759566 | PMC |
http://dx.doi.org/10.1186/s13063-023-07841-9 | DOI Listing |
Case Rep Surg
August 2025
Department of Trauma, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.
Chylous ascites from small bowel obstructions is a very rare finding with only a handful of case reports previously published. This case report of a patient with chylous ascites related to an obstruction from Petersen's hernia supports the trend from existing reports. Prior studies have linked chylous ascites to closed-loop obstructions, such as small bowel volvulus or internal hernia, even when the bowel is viable and does not require resection.
View Article and Find Full Text PDFInt J Surg Case Rep
August 2025
Department of Surgery, Al-Amiri Hospital, Ministry of Health Kuwait (MOH), Ibn Masbah, Block 3, PO Box 15000, East, Kuwait.
Introduction: The One Anastomosis Gastric Bypass (OAGB) is increasingly prevalent as a primary and revision bariatric surgical procedure as it demonstrates a remarkable weight loss outcome. One of the benefits of OAGB is the low incidence of internal hernias (IHs); IHs after OAGB have rarely been documented.
Case Presentation: We describe the laparoscopic repair of an IH in a 54-year-old female with a one-year history of OAGB performed as a revision surgery after sleeve gastrectomy for weight regain.
ACG Case Rep J
July 2025
Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX.
Petersen hernia is a rare complication that can occur following gastrojejunostomy procedures such as Roux-En-Y gastric bypass surgery. Bowel obstruction, ischemia, and mesenteric vessel thrombosis are recognized complications that can result in significant patient morbidity or mortality. In this study, we describe a case of mesenteric vein stenosis due to a Petersen hernia in a 61-year-old woman, manifesting as recurrent gastrointestinal bleeding.
View Article and Find Full Text PDFCureus
June 2025
Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, JPN.
Petersen hernia (PH) is a type of internal hernia in which a portion of the small intestine protrudes through a defect located between the small bowel limbs, transverse mesocolon, and retroperitoneum after any type of gastrojejunostomy. The laparoscopic approach facilitates the occurrence of this type of hernia owing to the lack of postoperative adhesions, which otherwise help prevent bowel motility and herniation. Closure of this anatomical space, formed between the jejunal mesentery, transverse mesocolon, and retroperitoneum, has been shown to significantly lower the incidence of hernia and associated complications such as bowel obstruction and strangulation.
View Article and Find Full Text PDF