Laparoscopy and complicated meckel diverticulum in children

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery

Background:

• Meckel diverticulum often presents with complications and is sometimes found incidentally.
• Laparoscopy is an established surgical approach for Meckel diverticulum management.

Purpose of the Study:

• To review the experience with complicated Meckel diverticulum in children treated with laparoscopy.
• To evaluate the safety and efficacy of laparoscopic management for pediatric Meckel diverticulum.

Main Methods:

• A 15-year retrospective chart review of 14 pediatric cases.
• Inclusion criteria: complicated Meckel diverticulum managed laparoscopically.
• Exclusion criteria: incidentally found diverticulum and laparotomy cases.

Main Results:

• Eight cases presented with small bowel obstruction, four with rectal bleeding, three with diverticulitis, and two with intussusception.
• Eleven patients underwent laparoscopic Meckel diverticulectomy; three required laparoscopic-assisted bowel resection due to extensive gangrene.
• Two patients with gangrene developed adhesions and were successfully treated with laparoscopic lysis.

Conclusions:

• Laparoscopy is a safe and effective method for managing complicated Meckel diverticulum in children.
• Simple diverticulectomy is sufficient for most cases; laparoscopy aids in diagnosis and complex resections.
• Laparoscopic approach minimizes incision size and allows thorough peritoneal lavage.