World Journal of Laparoscopic Surgery

Register      Login

VOLUME 13 , ISSUE 2 ( May-August, 2020 ) > List of Articles

Original Article

Laparoscopy-assisted Approach for Meckel's Diverticulum in Pediatric Age

Hesham Kasem, Mohamed Alekrashi, Wael Elshahat

Citation Information : Kasem H, Alekrashi M, Elshahat W. Laparoscopy-assisted Approach for Meckel's Diverticulum in Pediatric Age. World J Lap Surg 2020; 13 (2):65-68.

DOI: 10.5005/jp-journals-10033-1408

License: CC BY-NC 4.0

Published Online: 08-12-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Background: Meckel's diverticulum (MD) is the most common congenital gastrointestinal tract (GIT) anomaly, with incidence approximately 2–4%. It is usually asymptomatic and it is usually discovered accidentally during laparotomy or presenting with complication as perforation, bleeding, and bowel obstruction. The surgical treatment of MD includes exploratory laparotomy with either diverticulectomy or segmental small bowel resection. Materials and methods: A retrospective review performed for the cases of MD operated by laparoscopy-assistedexcision of the diverticulum in Zagazig University Hospital and International Medical Center Jeddah, during the period from November 2012 to October 2018, all data regarding patients’ demographics, clinical features, diagnostic tests performed, histopathology reports, operative time, conversion to laparotomy, hospital stay, and complications were analyzed. Results: This study includes 17 patients with MD who underwent laparoscopy-assisted excision of MD. The median age of the patients was 8.3 years. The male to female ratio was 11:6. Lower GIT bleeding was the most common presenting symptom. All patients were subjected to a laparoscopy-assisted excision. Four patients underwent wedge excision and 13 patients underwent segmental bowel resection. Conclusion: Laparoscopy-assisted resection of MD is safe, simple, and inexpensive. Moreover, it avoids the risk of intra-abdominal contamination.

  1. Kher YR, Nadkarni SP, Rao GL, et al. Meckel's diverticulum. A clinico-pathologic study of 123 cases. J Postgrad Med 1974;20(1):1–9.
  2. Kittle CF, Jenkins HP, Dragstedt LR. Patent omphalomesenteric duct and its relation to the diverticulum of Meckel. Arch Surg 1947;54(1): 10–36. DOI: 10.1001/archsurg.1947.01230070013002.
  3. Yahchouchy EK, Marano AF, Etienne JC, et al. Meckel's diverticulum. J Am Coll Surg 2001;192(5):658–662. DOI: 10.1016/S1072-7515(01) 00817-1.
  4. Kadian YS, Verma A, Rattan KN, et al. Vitellointestinal duct anomalies in infancy. J Neonatal Surg 2016;5(3):30. DOI: 10.21699/jns.v5i3.351.
  5. Palanivelu C, Rangarajan M, Senthilkumar R, et al. Laparoscopic management of symptomatic Meckel's diverticula: a simple tangential stapler excision. JSLS 2008;12(1):66–70.
  6. Chan KW, Lee KH, Mou JW, et al. Laparoscopic management of complicated Meckel's diverticulum in children: a 10 year review. Surg Endosc 2008;22(6):1509–1512. DOI: 10.1007/s00464-008-9832-0.
  7. Rangel SJ, Henry MC, Brindle M, et al. Small evidence for small incisions: pediatric laparoscopy and the need for more rigorous evaluation of novel surgical therapies. J Pediatr Surg 2003;38(10):1429–1433. DOI: 10.1016/S0022-3468(03)00491-3.
  8. Ure BM, Bax NM, van der Zee DC. Laparoscopy in infants and children: a prospective study on feasibility and the impact on routine surgery. J Pediatr Surg 2000;35(8):1170–1173. DOI: 10.1053/jpsu.2000. 8720.
  9. Park JJ, Wolff BG, Tollefson MK, et al. Meckel diverticulum: the mayo clinic experience with 1476 patients (1950–2002). Ann Surg 2005;241(3):529–533. DOI: 10.1097/01.sla.0000154270.14308.5f.
  10. Rho JH, Kim JS, Kim SY, et al. Clinical features of symptomatic Meckel's diverticulum in children: comparison of Scintigraphic and Non-scintigraphic diagnosis. Pediatr Gastroenterol Hepatol Nutr 2013;16(1):41–48. DOI: 10.5223/pghn.2013.16.1.41 [PMID: 24010105].
  11. Menezes M, Tareen F, Saeed A, et al. Symptomatic Meckel's diverticulum in children: a 16 year review. Pediatr Surg Int 2008;24(5):575–577. DOI: 10.1007/s00383-007-2094-4 [PMID: 18322689].
  12. Shalaby RY, Soliman SM, Fawy M, et al. Laparoscopic management of Meckel's diverticulum in children. J Pediatr Surg 2005;40(3):562–567. DOI: 10.1016/j.jpedsurg.2004.11.032 [PMID: 15793736].
  13. Attwood SE, McGrath J, Hill AD, et al. Laparoscopic approach to Meckel's diverticulectomy. Br J Surg 1992;79(3):211. DOI: 10.1002/bjs.1800790306 [PMID: 1532525].
  14. Cobellis G, Cruccetti A, Mastroianni L, et al. One-trocar transumbilical laparoscopic-assisted management of Meckel's diverticulum in children. J Laparoendosc Adv Surg Tech A 2007;17(2):238–241. DOI: 10.1089/lap.2006.0036 [PMID: 17484657].
  15. Sai Prasad TR, Chui CH, Singaporewalla FR, et al. Meckel's diverticular complications in children: is laparoscopy the order of the day? Pediatr Surg Int 2007;23(2):141–147. DOI: 10.1007/s00383-006-1844-z [PMID: 17171378].
  16. Prasad TR, Chui CH, Jacobsen AS. Laparoscopic-assisted resection of Meckel's diverticulum in children. JSLS 2006;10(3):310–316.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.