EN
TÜRKÇE
Poster - 356
Meckel’s diverticulum in children: laparoscopic technologies.
Olga Karaseva, Anna Timofeeva, Alexander Gorelik, Denis Golikov
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma - Dr. Roshal's Clinic
Relevance: Meckel’s diverticulum is the most common congenital malformation of the gastrointestinal tract. In 95% it is asymptomatic, what explains the difficulties in diagnosis. Preoperative diagnosis is made only in 10% of cases.
Aim: To show the opportunities of laparoscopy in diagnosis and management of Meckel’s diverticulum in children.
Methods: During 2011-2024 Meckel’s diverticulum was diagnosed in 69 children. Boy to girl ratio was 2:1, mean age – 8.6±5.3 years. Most children (67) were emergently hospitalized with acute abdomen and only 2 children were hospitalized as planned with established diagnosis of Meckel’s diverticulum. Final diagnosis was performed using laparoscopy in all cases. 63 children (91.3%) were operated for diverticulum during the first operation, in 6 children Meckel diverticulectomy was not performed. Surgical tactic differed depending on the type of diverticulum.
Results: In 59.4% (41) of children complicated Meckel’s diverticulum was seen. Complications included: ileus in 18.8%, perforation in 17.4%, gastrointestinal bleeding in 11.4%, intestinal intussusception in 10.1%, necrosis in 7.2% and inflammation in 4.3%. Diagnostic laparoscopy was performed in all children. Laparoscopy was performed under endotracheal anesthesia in supine position using three trocars: 11 mm (optic) in the umbilicus region, 5 mm (instruments) in left iliac region and in hypogastrium. 44 children (68.3%) were treated totally laparosopically, in the rest 19 children laparotomy was performed. During laparoscopic diverticulectomy an ultrasound dissector was used in 30 (68.2%) children, surgical stapling device was used in 12 (27.3%) children and in two girls diverticulectomy, resection of the part of the bowel and end-to-end anastomosis was performed. No intraoperative complications were observed. The postop period was normal in all children. Histological examination confirmed the diagnosis.
Conclusion: Laparoscopy in Meckel’s diverticulum allows not only to confirm the diagnosis but also to manage the pathology in minimally invasive way.