THE NECESSITY OF MESENTERIC DEFECT CLOSURE DURING LAPAROSCOPIC COLECTOMIES
DOI:
https://doi.org/10.11603/2414-4533.2026.1.15772Keywords:
laparoscopic colorectal resection, colonic mesentery, mesenteric defect, mesenteric defect closure, internal hernia, bowel obstruction, postoperative complications, quality of life, complication preventionAbstract
The aim of the work: to determine the feasibility of mesenteric defect closure based on a retrospective analysis of outcomes after laparoscopic colorectal resections.
Materials and Methods. A retrospective analysis of 57 laparoscopic colorectal resections performed between 2018 and 2024 was conducted. Operative time, postoperative complications, development of bowel obstruction, and length of hospital stay were evaluated. In some patients the mesenteric defect was closed, while in others it was left open.
Results. Cases of internal entrapment of small bowel loops with subsequent bowel obstruction were observed exclusively in patients in whom the mesenteric defect was not closed. Closure of the mesenteric defect was not associated with an increased rate of postoperative complications or prolonged hospital stay. No significant differences in length of hospitalization were found between the groups with closed and non-closed defects.
Conclusions. Closure of the mesenteric defect during laparoscopic right- and left-sided colorectal resections is advisable and allows reduction of the risk of internal small bowel entrapment and acute postoperative bowel obstruction.
Received: 15.12.2025 | Revised: 20.01.2026 | Accepted: 19.02.2026
References
Xu W, Zhou J. The value of mesenteric closure after laparoscopic right hemicolectomy: a scoping review. BMC Surg. 2023; 23(1):1-9. DOI: 10.1186/s12893-023-02033-3. DOI: https://doi.org/10.1186/s12893-023-02033-3
Zhuang CL, Huang DD, Chen FF, Zhou CJ, Zheng BS, Chen BC, et al. Laparoscopic versus open colorectal surgery within enhanced recovery after surgery programs: a systematic review and meta-analysis of randomized controlled trials. Surg Endosc. 2015; 29(8):2091-100. DOI: 10.1007/s00464-014-3922-y. DOI: https://doi.org/10.1007/s00464-014-3922-y
Matsuda T, Yamashita K, Hasegawa H, Utsumi M, Kakeji Y. Current status and trend of laparoscopic right hemicolectomy for colon cancer. Ann Gastroenterol Surg. 2020; 4(5):521-27. DOI: 10.1002/ags3.12373. DOI: https://doi.org/10.1002/ags3.12373
Sugita H, Akiyama T, Daitoku N, Tashima R, Tanaka H, Honda S, et al. Internal hernia after laparoscopic right hemicolectomy: report of a case. J Surg Case Rep. 2017; 2017(5):rjw217. DOI: 10.1093/jscr/rjw217. DOI: https://doi.org/10.1093/jscr/rjw217
Daster S, Xiang H, Yang J, Rowe D, Keshava A, Rickard M. High prevalence of asymptomatic internal hernias after laparoscopic anterior resection in a retrospective analysis of postoperative computed tomography. Int J Colorectal Dis. 2020; 35(5):929-32. DOI: 10.1007/s00384-020-03537-7. DOI: https://doi.org/10.1007/s00384-020-03537-7
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018; 169(7):467-73. DOI: 10.7326/M18-0850. DOI: https://doi.org/10.7326/M18-0850
Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018; 18(1):143. DOI: 10.1186/s12874-018-0611-x. DOI: https://doi.org/10.1186/s12874-018-0611-x
Ruiz-Perez I, Petrova D. Scoping reviews: another way of literature review. Med Clin (Barc). 2019;153(4):165-68. DOI: 10.1016/j.medcli.2019.02.006. DOI: https://doi.org/10.1016/j.medcle.2019.02.026
Sica GS, Franceschilli M, Sensi B, Siragusa L, Vinci D, Bellato V. Mesenteric closure with polymer-ligating clips after right colectomy with complete mesocolic excision for cancer and mesentery-based ileocolic resection for Crohn’s disease. Tech Coloproctol. 2021; 25(9):1079-084. DOI: 10.1007/s10151-021-02493-w. DOI: https://doi.org/10.1007/s10151-021-02493-w
Vignali A, Elmore U, Lemma M, Guarnieri G, Radaelli G, Rosati R. Intracorporeal versus extracorporeal anastomoses following laparoscopic right colectomy in obese patients: a case-matched study. Dig Surg. 2018; 35(3):236-42. DOI: 10.1159/000479241. DOI: https://doi.org/10.1159/000479241
Al-Saadi N, Devani P, Hunter DI, Bowrey DJ. A mesenteric defect causing internal herniation and ischaemia of both the ascending and sigmoid colons, treated with a bowel-preserving surgery. BMJ Case Rep. 2021; 14(6):e242098. DOI: 10.1136/bcr-2021-242031. DOI: https://doi.org/10.1136/bcr-2021-242031
Baldari L, Boni L, Della Porta M, Bertani C, Cassinotti E. Management of intraoperative complications during laparoscopic right colectomy. Minerva Surg. 2021; 76(4):294-302. DOI: 10.23736/S2724-5691.21.08771-2. DOI: https://doi.org/10.23736/S2724-5691.21.08771-2
Velotti N, Manigrasso M, Di Lauro K, Vertaldi S, Anoldo P, Vitiello A, et al. Barbed suture in gastrointestinal surgery: a review with a meta-analysis. Surgeon. 2022; 20(2):115-22. DOI: 10.1016/j.surge.2021.02.011. DOI: https://doi.org/10.1016/j.surge.2021.02.011
Wu D, Jin W, Zhang Y, An Y, Chen X, Chen W. Primary suture of the common bile duct: continuous or interrupted? J Laparoendosc Adv Surg Tech A. 2022; 32(4):390-94. DOI: 10.1089/lap.2021.0215. DOI: https://doi.org/10.1089/lap.2021.0215
Demetriou G. Mesenteric defects following bowel resection: how to manage. Br J Surg. 2019; 106(Suppl 6):31. DOI: https://doi.org/10.1002/bjs.11167. DOI: https://doi.org/10.1002/bjs.11167
Ricci C, Casadei R, Alagna V, Zani E, Taffurelli G, Pacilio CA, et al. A critical and comprehensive systematic review and meta-analysis of studies comparing intracorporeal and extracorporeal anastomosis in laparoscopic right hemicolectomy. Langenbecks Arch Surg. 2017; 402(3):417-27. DOI: 10.1007/s00423-016-1509-x. DOI: https://doi.org/10.1007/s00423-016-1509-x
Downloads
Published
Issue
Section
License
Copyright (c) 2026 В. В. ГРУБНІК, К. О. ВОРОТИНЦЕВА, В. М. КОСОВАН, С. П. ДЕГТЯРЕНКО
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
