Clinical outcomes of minimally invasive surgery for Meckel diverticulum: a multicenter study

Abstract

Meckel diverticulum (MD), which is caused by an obliteration defect of the omphalomesenteric duct (vitelline duct or yolk sac), is one of the most common congenital anomalies of the small intestine [1]. It was first described by Johann Friedrich Meckel in 1808 and is also termed omphalomesenteric duct fistula, cyst, or sinus [2,3]. Although it is found incidentally during abdominal surgery for other pathologies, it can be associated with several complications, including congenital hernia, intestinal bleeding, bowel obstruction due to intussusception or fibrous band, and panperitonitis due to MD perforation [4-7]. Conventional surgical treatment of MD has involved exploratory laparotomy with simple diverticulectomy, wedge resection, or small bowel resection and anastomosis [8,9]. With recent advances in laparoscopic techniques, minimally invasive

Meckel's diverticulum: analysis of 27 cases in an adult population

“…Surgical management is considered mandatory for symptomatic cases of Meckel's diverticulum, although the appropriate management of incidentally discovered Meckel's diverticula is still controversial. The type of surgical procedure and approach in adult patients also remains to be a matter of debate ( 9 , 28 ). The surgical option for treating this condition includes diverticulectomy and wedge and segmental resection, with segmental resection considered the most appropriate procedure with high success rates due to a complete resection of the ectopic tissue ( 9 , 28 ).…”

“…The type of surgical procedure and approach in adult patients also remains to be a matter of debate ( 9 , 28 ). The surgical option for treating this condition includes diverticulectomy and wedge and segmental resection, with segmental resection considered the most appropriate procedure with high success rates due to a complete resection of the ectopic tissue ( 9 , 28 ). Some authors categorize the procedure depending on the length of the diverticula and the type of complication.…”

“…For long diverticula with simple diverticulitis, active bleeding, or an incidental finding, diverticulectomy is the recommended treatment. However, if the diverticula is short (with a height to diameter ratio of <2 cm), wedge and segmental resection is the most effective approach ( 9 , 28 ). In these cases, it is crucial to avoid incomplete resection of ectopic tissue, which can be determined either by palpation or by diverticula size ( 9 , 28 ).…”

“…However, if the diverticula is short (with a height to diameter ratio of <2 cm), wedge and segmental resection is the most effective approach ( 9 , 28 ). In these cases, it is crucial to avoid incomplete resection of ectopic tissue, which can be determined either by palpation or by diverticula size ( 9 , 28 ). Some authors such as Ezekian et al ( 9 , 28 ) suggest that conventional palpation could be avoided, and minimally invasive approaches can be performed without increasing morbidity and mortality rates, a finding consistent with the study reported by Jung et al ( 9 , 28 ), with acceptable complication rates and high success rates, when preoperative ileus and older age are considered as predictors of complications ( 9 , 28 ).…”

“…In these cases, it is crucial to avoid incomplete resection of ectopic tissue, which can be determined either by palpation or by diverticula size ( 9 , 28 ). Some authors such as Ezekian et al ( 9 , 28 ) suggest that conventional palpation could be avoided, and minimally invasive approaches can be performed without increasing morbidity and mortality rates, a finding consistent with the study reported by Jung et al ( 9 , 28 ), with acceptable complication rates and high success rates, when preoperative ileus and older age are considered as predictors of complications ( 9 , 28 ). In our study, patients with intestinal obstruction were most frequently treated by laparotomy approach when compared with bleeding, simple diverticula, or incidental findings.…”