One-trocar transumbilical laparoscopic-assisted management of Meckel's diverticulum in children.
OBJECTIVE
Transumbilical laparoscopic-assisted intestinal surgery using only "one trocar" is a very minimal invasive procedure. The authors present their experience for the management of Meckel's diverticulum.


METHODS
Between January 2001 and December 2004, 9 transumbilical laparoscopic-assisted procedures were performed for Meckel's diverticulum. The median age of the patients was 6.1 years (range, 6 months-13.6 years). Six patients were admitted for intestinal bleeding and technetium-99m pertechnetate scan was positive in 3. Three patients had recurrent abdominal pain and abdominal ultrasound scan showed a cystlike structure. An intraumbilical Hasson 10-mm trocar was inserted in an open fashion. Using a 10-mm operative laparoscope, the terminal ileum was grasped with an atraumatic instrument and exteriorized through the umbilicus. Ileal exploration and treatment were performed extracorporeally.


RESULTS
Meckel's diverticulum was identified in 8 patients and ileal duplication in 1 patient: intestinal resection/anastomosis (n = 7) or excision of diverticulum (n = 2) was performed. There were no operative complications. Median hospital stay was 4 days (range, 3-7 days). At a median followup of 24 months (range, 3-51 months), all patients are asymptomatic.


CONCLUSIONS
Our results indicate that the one trocar transumbilical laparoscopic-assisted procedure is safe and effective for the diagnosis and treatment of Meckel's diverticulum, with excellent cosmetic results.
Cobellis
Giovanni
G
Pediatric Surgery Unit, Salesi Children's Hospital, Ancona, Italy.
Cruccetti
Alba
A
Mastroianni
L
L
Amici
G
G
Martino
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007082:Ileum / Q000002:abnormalities / Q000601:surgery; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008467:Meckel Diverticulum / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome