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Laparoscopy-assisted Approach for Meckel’s Diverticulum in Pediatric Age
outside of the abdomen which is easy and associated with less risk 3. Yahchouchy EK, Marano AF, Etienne JC, et al. Meckel’s diverticulum.
for intra-abdominal contamination, also direct palpation on the J Am Coll Surg 2001;192(5):658–662. DOI: 10.1016/S1072-7515(01)
base of the diverticulum and measurement of the height/diameter 00817-1.
(HD) ratio could assist the plan of the surgical resection. 6,12,16 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.
In order to achieve proper surgical plan, some authors studied 5. Palanivelu C, Rangarajan M, Senthilkumar R, et al. Laparoscopic
the relationship between the location of ectopic gastric mucosa management of symptomatic Meckel’s diverticula: a simple
in the diverticulum and the external appearance of diverticulum tangential stapler excision. JSLS 2008;12(1):66–70.
and they conclude that in cases of long diverticula with a H/D 6. Chan KW, Lee KH, Mou JW, et al. Laparoscopic management of
ratio of >1.6 the heterotopic mucosa is only located in the complicated Meckel’s diverticulum in children: a 10 year review. Surg
distal area; so in these cases, simple diverticulectomy has been Endosc 2008;22(6):1509–1512. DOI: 10.1007/s00464-008-9832-0.
recommended. And in case of broad base or short diverticulum, 7. Rangel SJ, Henry MC, Brindle M, et al. Small evidence for small incisions:
resection of segment of the bowel containing the MD and an end- pediatric laparoscopy and the need for more rigorous evaluation of
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to-end anastomosis is preferred. In our study, we did resection novel surgical therapies. J Pediatr Surg 2003;38(10):1429–1433. DOI:
10.1016/S0022-3468(03)00491-3.
anastomosis in 13 patients and wedge resection in 4 patients. 8. Ure BM, Bax NM, van der Zee DC. Laparoscopy in infants and
In one case, we did laparoscopy-assisted diverticulectomy using children: a prospective study on feasibility and the impact on routine
linear stapler device was performed. It has been reported that surgery. J Pediatr Surg 2000;35(8):1170–1173. DOI: 10.1053/jpsu.2000.
adhesive intestinal obstruction is the most common complication 8720.
after a Meckel’s diverticulectomy, which occurs in 5 to 10% of 9. Park JJ, Wolff BG, Tollefson MK, et al. Meckel diverticulum: the
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the cases. 12,13 In a study performed by Chan et al., 20 patients mayo clinic experience with 1476 patients (1950–2002). Ann Surg
underwent laparoscopy-assisted excision of MD and reported that 2005;241(3):529–533. DOI: 10.1097/01.sla.0000154270.14308.5f.
none of the patients were readmitted for rebleeding or developed 10. Rho JH, Kim JS, Kim SY, et al. Clinical features of symptomatic
adhesive intestinal obstruction. In our series, we have conversion Meckel’s diverticulum in children: comparison of Scintigraphic and
Non-scintigraphic diagnosis. Pediatr Gastroenterol Hepatol Nutr
to minilaparotomy in one patient and reexploration in one 2013;16(1):41–48. DOI: 10.5223/pghn.2013.16.1.41 [PMID: 24010105].
patient in which the first diagnostic laparoscopy was negative and 11. Menezes M, Tareen F, Saeed A, et al. Symptomatic Meckel’s
reexploration was performed due to recurrent lower GIT bleeding, diverticulum in children: a 16 year review. Pediatr Surg Int
and one patient develop adhesive intestinal obstruction which was 2008;24(5):575–577. DOI: 10.1007/s00383-007-2094-4 [PMID:
managed by conservative treatment. 18322689].
The limitation of the study is being retrospective in nature and 12. Shalaby RY, Soliman SM, Fawy M, et al. Laparoscopic management of
small number of cases. Meckel’s diverticulum in children. J Pediatr Surg 2005;40(3):562–567.
DOI: 10.1016/j.jpedsurg.2004.11.032 [PMID: 15793736].
conclusIon 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/
Laparoscopy-assisted resection of MD is minimally invasive, bjs.1800790306 [PMID: 1532525].
simple, and safe procedure that avoid the risk of intra-abdominal 14. Cobellis G, Cruccetti A, Mastroianni L, et al. One-trocar transumbilical
complication from bowel resection and anastomosis. 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].
references 15. Sai Prasad TR, Chui CH, Singaporewalla FR, et al. Meckel’s diverticular
1. Kher YR, Nadkarni SP, Rao GL, et al. Meckel’s diverticulum. A clinico- complications in children: is laparoscopy the order of the day? Pediatr
pathologic study of 123 cases. J Postgrad Med 1974;20(1):1–9. Surg Int 2007;23(2):141–147. DOI: 10.1007/s00383-006-1844-z [PMID:
2. Kittle CF, Jenkins HP, Dragstedt LR. Patent omphalomesenteric duct 17171378].
and its relation to the diverticulum of Meckel. Arch Surg 1947;54(1): 16. Prasad TR, Chui CH, Jacobsen AS. Laparoscopic-assisted resection
10–36. DOI: 10.1001/archsurg.1947.01230070013002. of Meckel’s diverticulum in children. JSLS 2006;10(3):310–316.

68 World Journal of Laparoscopic Surgery, Volume 13 Issue 2 (May–August 2020)