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Laparoscopic management of complicated Meckel's diverticulum in children: a 10-year review
1Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Hong Kong SAR, China. edwinchan@surgery.cuhk.edu.hk
Insights
Laparoscopy is a safe and effective surgical approach for managing complicated Meckel
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Minimally Invasive Surgery
Background:
- Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract.
- Complications of Meckel's diverticulum are frequent in the pediatric population.
- This study evaluates a 10-year experience with laparoscopic management of complicated Meckel's diverticulum in children.
Purpose of the Study:
- To assess the efficacy and safety of laparoscopy for managing complicated Meckel's diverticulum in pediatric patients.
- To report outcomes of laparoscopic Meckel's diverticulectomy in children.
Main Methods:
- Retrospective review of pediatric cases with complicated Meckel's diverticulum (1998-2007).
- All patients underwent diagnostic laparoscopy.
- Laparoscopically assisted transumbilical Meckel's diverticulectomy was performed when indicated.
Main Results:
- Twenty children (17 boys, 3 girls; mean age 5 years) were included.
- Presentations included gastrointestinal bleeding (12), intestinal obstruction (2), abdominal pain (3), inguinal hernia (2), and intussusception (1).
- Successful laparoscopic diverticulectomy in 18/20 patients with a mean operative time of 115 minutes; one postoperative wound infection.
Conclusions:
- Meckel's diverticulum can cause various pediatric surgical conditions.
- Laparoscopy is a safe and effective surgical method for managing complicated Meckel's diverticulum in children.
- Ectopic gastric mucosa was a frequent finding (14/20 cases).
Background:
Meckel's diverticulum, the most common congenital anomaly of the gastrointestinal tract, is prone to develop complications in the pediatric population. The authors report their 10-year experience with the management of complicated Meckel's diverticulum in children using laparoscopy.
Methods:
A retrospective review of all complicated Meckel's diverticulum cases involving children from 1998 to 2007 was performed. The efficacy and safety of laparoscopy used to manage complicated Meckel's diverticulum were assessed.
Results:
Over a 10-year period, 20 children (17 boys and 3 girls) with a mean age of 5 years (range, 7 months to 13 years) were included in the study. Of the 20 children, 12 presented with gastrointestinal bleeding, 2 had intestinal obstruction, 3 had abdominal pain mimicking acute appendicitis, 2 had inguinal hernia, and 1 had intussusception. Diagnostic laparoscopy was performed for all the patients. Laparoscopically assisted transumbilical Meckel's diverticulectomy was performed successfully for 18 of the children. The operative time ranged from 50 to 190 min (mean, 115 min). All the children had an uneventful recovery except one, who experienced a postoperative wound infection. Ectopic gastric mucosa was found in 14 cases.
Conclusions:
Diverse pediatric surgical conditions result from Meckel's diverticulum. Laparoscopy is a safe and effective method for the management of complicated Meckel's diverticulum.
