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Laparoscopic removal of Meckel's diverticula in children
F Schier1, K Hoffmann, J Waldschmidt
1University Medical Center Steglitz, Berlin, Germany.
Abstract:
We report on 4 children where Meckel's diverticula (MD) were excised laparoscopically. In two of the children the finding of an MD was incidental and in two it was suspected preoperatively. In three of the patients the MD was ligated by means of an "endoloop" and could be removed in a similar manner to an appendix. In one patient the MD was resected by means of a stapler. No complications occurred. Subsequent histology confirmed the complete excision of the MD. Allowing for the size and shape of an MD, we prefer to excise it by means of an endoloop. An endoloop has the advantage that it can be used through a 5 mm trocar while a stapler has the disadvantage that it requires a larger 12 mm trocar and it leaves a foreign body, i.e. metal clips behind.
Insights
Laparoscopic surgery for Meckel's diverticula (MD) in children is safe and effective. The endoloop method is preferred for excising MD due to its minimally invasive nature and avoidance of retained foreign bodies.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Meckel's diverticula (MD) are congenital anomalies that can cause significant complications.
- Laparoscopic approaches are increasingly utilized for pediatric surgical procedures.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic excision of Meckel's diverticula in children.
- To compare different laparoscopic techniques for MD excision.
Main Methods:
- Retrospective review of 4 pediatric patients undergoing laparoscopic Meckel's diverticulectomy.
- Procedures included endoloop ligation (n=3) and stapler resection (n=1).
- Histological confirmation of complete MD excision was performed.
Main Results:
- All 4 patients underwent successful laparoscopic MD excision without complications.
- Histology confirmed complete resection in all cases.
- The endoloop technique was feasible through a 5 mm trocar, while the stapler required a 12 mm trocar and left metallic clips.
Conclusions:
- Laparoscopic Meckel's diverticulectomy is a safe and effective treatment for pediatric patients.
- Endoloop ligation is a preferred method for laparoscopic MD excision, offering advantages in terms of trocar size and avoidance of foreign material.