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Internal hernia following laparoscopic gastric bypass

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Title: Internal hernia following laparoscopic gastric bypass
Authors: Ahmed, Ahmed Rashid
Item Type: Thesis or dissertation
Abstract: Obesity is increasingly recognised as a major health threat in the developed world, with more than 120 million people worldwide classified as clinically obese. Increased weight causes increased morbidity and mortality due to its association with cardiovascular disease, diabetes and certain cancers. Bariatric surgery is currently the most efficacious treatment for morbid obesity and has the best long-term outcomes. Bariatric surgery is not without risks. Some of the early risks include postoperative bleeding, anastomotic leaks, and venous thromboembolism. Late complications include marginal ulcer formation, nutritional deficiencies and small bowel obstruction. The latter may be caused by internal hernia formation. In this thesis, an analysis of the causes of small bowel obstruction after laparoscopic Roux-en-Y gastric bypass (LRYGB) is presented, looking specifically at internal hernia formation. A detailed account of the presentation and radiological findings of internal hernia following laparoscopic gastric bypass is provided. The impact of altering surgical technique on the occurrence of internal hernia is analysed: an Observational Clinical Human Reliability Assessment (OCHRA) tool was used for root cause analysis of internal hernia following gastric bypass and in the final study, the employment of a new technique demonstrated significant reduction in the incidence of internal hernia.
Content Version: Open Access
Issue Date: Mar-2014
Date Awarded: Jun-2014
URI: http://hdl.handle.net/10044/1/24733
DOI: https://doi.org/10.25560/24733
Supervisor: Hanna, George
Bloom, Steven
Le Roux, Carel
Department: Medicine
Publisher: Imperial College London
Qualification Level: Doctoral
Qualification Name: Doctor of Philosophy (PhD)
Appears in Collections:Medicine PhD theses



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