TITLE

Video-Assisted Transumbilical Meckel's Diverticulectomy in Children

AUTHOR(S)
Clark, Jason M.; Koontz, Curt S.; Smith, Lisa A.; Kelley, Joseph E.
PUB. DATE
April 2008
SOURCE
American Surgeon;Apr2008, Vol. 74 Issue 4, p327
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The treatment of Meckel's diverticulum (MD) in children is resection. Some data exist for the use of laparoscopic resection. The Video-Assisted Transumbilical (VAT) single-trocar technique has been recently described for appendectomy. We also have used this technique for the resection of MD. The purpose of this study is to report our experience with laparoscopic -assisted resection of MD using both the three-trocar and the single-trocar techniques. The Institutional Review Board approved our retrospective chart review of all patients with the diagnosis of MD. Only the cases that were treated via laparoscopy were included. Technique of resection was at the discretion of the surgeon. Nine patients underwent laparoscopic resection of an MD from 2000 to 2005. Four patients underwent the three-trocar technique (LAP n = 4) and the remaining five underwent the video-assisted transumbilical single-trocar technique (VAT n = 5) procedure. Indications for surgery included gastrointestinal bleeding (VAT n = 3; LAP n = 2), malrotation (LAP n = 2), intussusception (VAT n = 1), and abdominal pain (VAT n = 1). All patients were male, and ages ranged from 7 months to 17 years for the VAT group and 8 months to 15 years for the LAP group. The average length of surgery for the LAP versus VAT was 128 minutes (94-170 minutes) and 81.4 minutes (42-96 minutes) respectively. Of the five patients undergoing LAP, two Ladd's procedures and three appendectomies were included during the same anesthesia. Only a single appendectomy procedure was performed during a VAT. The average time until full feeds with the LAP and VAT was 4.3 days (2-8 days) and 2.0 days (1-3 days) respectively. The overall length of stay with LAP versus VAT was 4.3 days (2-8 days) and 3.7 days (2-5 days). Only one case using the LAP method required conversion to an open laparotomy. Though no randomized trial for the removal of MD exists, our data suggest that the use of laparoscopy for removal of both symptomatic and asymptomatic MD is safe and effective. Additionally, the one trocar technique is feasible and may be beneficial in terms of fewer incisions and operative costs; however, more patients need to be studied.
ACCESSION #
31656298

 

Related Articles

  • Stump Appendicitis: Does it Occur More Frequently after Laparoscopic or Conventional Appendectomy? - Report of a Case. Von Einem, Gina; Denecke, Timm; Grieser, Christian; Glanemann, Matthias; Andreou, Andreas // Open Surgery Journal;2011, Vol. 5, p19 

    We here present a case of stump appendicitis as a late complication after laparoscopic appendectomy. The literature showed that the occurrence of stump appendicitis correlated with the length of the remaining appendix stump. To prevent stump appendicitis it is important to correctly identify the...

  • Single-incision two port laparoscopic appendicectomy -- How we do it? Vaithianathan, Rajan; Rajendiran, Kannan; Santhanam, Ramachandran // Journal of Medical & Allied Sciences;2013, Vol. 3 Issue 1, p38 

    The next advancement in the field of minimally invasive surgery, in the recent times, has been the use of single-incision for accessing the abdominal cavity. Potential benefits of single-incision laparoscopic surgery (SILS) are decreased postoperative pain, reduced port site complications and...

  • Laparoscopic appendicectomy surgery using spinal anesthesia. Patel, Dhaval; Patel, H. V. // International Archives of Integrated Medicine;Mar2015, Vol. 2 Issue 3, p103 

    Laparoscopic abdominal surgery is conventionally done under general anesthesia. Spinal anesthesia is usually preferred in patients where general anesthesia is contraindicated. We have presented here our experience using spinal anesthesia as the first choice for laparoscopic surgery for over 2...

  • Implications of Removing a Normal Appendix. Bijnen, C. L.; Van den Broek, W. T.; Bijnen, A. B.; De Ruiter, P.; Gouma, D. J. // Digestive Surgery;2003, Vol. 20 Issue 2, p115 

    Background: The diagnosis of acute appendicitis remains difficult, and therefore 15-30% of the removed appendices appear to be normal. The aim of this study is to investigate the morbidity, mortality and costs of removing a normal appendix in patients with suspected appendicitis. Patients and...

  • Does Primary Anastomosis with Diversion Have Any Advantages over Hartmann's Procedure in Acute Diverticulitis? Masoomi, Hossein; Stamos, Michael J.; Carmichael, Joseph C.; Nguyen, Brian; Buchberg, Brian; Mills, Steven // Digestive Surgery;2012, Vol. 29 Issue 4, p315 

    Background: The optimal treatment for acute complicated diverticulitis is still a matter of debate. We evaluated outcomes of primary anastomosis with proximal diversion (PAD) versus Hartman's procedure (HP) in acute diverticulitis. Methods: Using the National Inpatient Sample database, we...

  • Abdominal scar endometriosis after Caesarean section: a rare entity. Sinha, Ruchi; Kumar, Mohan; Matah, Manjari // Australasian Medical Journal;Jan2011, Vol. 4 Issue 1, p60 

    Scar endometriosis is an uncommon entity. It is often misdiagnosed leading to unnecessary referrals. Gynaecologists and general surgeons must be aware of this entity to avoid discomfort to the patient due to delay in diagnosis. We are presenting a case of scar endometriosis which was...

  • The Feny&oumi;-Lindberg scoring system for appendicitis increases positive predictive value in fertile women. Enochsson, L.; Gudbjartsson, T.; Hellberg, A.; Rudberg, C.; Wenner, J.; Ringqvist, I.; Sörensen, S.; Fenyö, G. // Surgical Endoscopy;Oct2004, Vol. 18 Issue 10, p1509 

    Background: Suspected appendicitis is one of the most common indications for acute laparotomy or laparoscopy. The negative laparotomy and laparoscopy rates are high, often in the range of 15-30%, and especially high in some groups of patients such as women child-bearing age and young patients....

  • Laparoscopic Lysis of Adhesions. Szomstein, Samuel; Menzo, Emanuele; Simpfendorfer, Conrad; Zundel, Nathan; Rosenthal, Raul // World Journal of Surgery;Apr2006, Vol. 30 Issue 4, p535 

    Background: Intra-abdominal adhesions constitute between 49% and 74% of the causes of small bowel obstruction. Traditionally, laparotomy and open adhesiolysis have been the treatment for patients who have failed conservative measures or when clinical and physiologic derangements suggest toxemia...

  • Stump Appendicitis: A Bane or Boon of Laparoscopic Appendectomy. Sreeramulu, P. N.; Shetty, Nikhil S.; Mahesh, Babu B.; Asadulla, Baig; Supreeth, C. S. // World Journal of Laparoscopic Surgery;Jan-Apr2011, Vol. 4 Issue 1, p5 

    Appendiceal stump appendicitis is a very rare surgical event, though acute appendicitis is still the most common cause of abdominal surgeries worldwide. The incidence of appendiceal stump appendicitis is on a gradual rise possibly due to laparoscopic surgeries. In this study, we report a...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics