Page 19 - Journal of Laparoscopic Surgery

WJOLS

Current Laparoscopic Management of Symptomatic Meckel’s Diverticulum

gastrointestinal bleeding with or without anemia and would 2. Sai Prasad TR, et al. Meckel’s diverticular complications in
have had endoscopic or radiological imaging of the GIT and children: Is laparoscopy the order of the day? Pediatr Surg Int
2007;23:141-47.
possibly 99Tc pertechnetate scintigraphy (Meckel scan). The 3. Shalaby RY, et al. Laparoscopic management of Meckel’s
sensitivity of the Meckel scan, however, may only be in the diverticulum in children. Journal of Pediatric Surgery 2005;40:
region of 60 to 66% 11,12 and carries a relatively high false- 562-67.
12
negative rate. In cases, where investigations and clinical 4. Clark JM, et al. Video-assisted transumbilical Meckel’s
suspicion favor the diagnosis of Meckel’s diverticulum which diverticulectomy in children. The American Surgeon. April
2008;74(4):327-29.
seem most appropriate to proceed with the novel single-port 5. Chan KW, et al. Laparoscopic management of complicated
video-assisted transumbilical procedure proposed by both Meckel’s diverticulum in children: A 10-year review. Surg Endosc
4
Clark and Cobellis. 6 2008;22:1509-12.
6. Cobellis G, et al. One-trocar transumbilical laparoscopic-assisted
CONCLUSION AND RECOMMENDATION management of Meckel’s diverticulum in children. Journal of
Laparoendoscopic and Adv Surg Tech 2007;17:238-41.
This study illustrates the fact that the laparoscopic era brings 7. Palanivelu C, et al. Laparoscopic management of symptomatic
with it novel approaches to old pathologies. Large-scale trials Meckel’s diverticula: A simple tangential stapler excision. JSLS
2008;12:66-70.
comparing specific therapeutic strategies are unlikely to occur. 8. Cullen JJ, et al. Surgical management of Meckel’s diverticulum:
From the available evidence, however, we can conclude that all An epidemiologic, population-based study. Ann Surg 1994;220:
current laparoscopic techniques in the management of Meckel’s 564-69.
diverticulum are both safe and effective with no significant 9. Mukai M, et al. Does the external appearance of a Meckel’s
difference in outcome between them. In the appropriate clinical diverticulum assist in choice of laparoscopic procedure? Pediatr
Surg Int 2002;18:231-33.
setting, I would however suggest that preference be given to 10. Bona D, et al. Laparoscopic resection for incidentally detected
either LAMD or VATMD rather than ‘conventional’ LMD using Meckel diverticulum. World J Gastroenterol Aug 2008;14(31):
an intracorporeal stapler-cutter. 4961-63.
11. Menezes M, et al. Symptomatic Meckel’s diverticulum in
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12. Swaniker F, et al. The utility of technetium 99 m pertechnetate
1. Mackey WC, Dineen P. A fifty-year experience with Meckel’s scintigraphy in the evaluation of patients with Meckel’s
diverticulum. Surg Gynecolo Obstet Jan 1983;156(1):56-64. diverticulum. J Pediatr Surg May 1999;34(5):760-64.

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