title: Rescue Radioguided Laparoscopy Surgery for Meckel's Diverticulum: Technical Notes.
abstract: The extirpation of Meckel's diverticulum (MD) via conventional or laparoscopic surgery is the definitive treatment. However, certain circumstances may modify or alter this situation and require the application of exceptional measures.We report a case under our observation who previously had an exploratory abdominal laparotomy for a suspected MD; however, the findings were negative. At that time, the diagnosis was established based on low-level gastrointestinal bleeding and isotopic tests that confirmed the existence of the diverticulum. Given the findings of gamma-graphic exploration and the previous negative surgical exploration, a decision was made to remove the lesion by laparoscopic radioguided surgery.The patient underwent bilateral laparoscopic radioguided surgery using a gamma radiation detection probe. The exploration of the abdominal cavity noted the existence of the diverticulum about 60 to 70  cm from the ileocecal valve. In this way, it was possible to proceed with the resection of the bowel loop and perform an intracorporeal anastomosis termino lateral. The postoperative course was uneventful, and the patient was discharged on the fifth postoperative day.We believe that the combination of radioguided surgery and single photon emission computed tomography/computed tomography could be useful for treating lesions in locations that are surgically difficult because of the characteristics of the lesion itself or the peculiarities of an individual patient.
authors.affiliation: From Department of Surgery, University Hospital, Zaragoza, Spain (JD, AM, MS, IG); Department of Nuclear Medicine, University Hospital, Zaragoza, Spain (AA, EP); Department of Podiatry, University of Sevilla, Sevilla, Spain (JS); Department of Human Anatomy and Histology, University of Zaragoza, Zaragoza, Spain (ML); and Department of Radiology, University of Zaragoza, Zaragoza, Spain (MADG).
authors.forename: Javier
authors.initials: J
authors.lastname: Deus
authors.forename: Alfonso
authors.initials: A
authors.lastname: Millera
authors.forename: Alejandro
authors.initials: A
authors.lastname: Andrés
authors.forename: Enrique
authors.initials: E
authors.lastname: Prats
authors.forename: Manuel
authors.initials: M
authors.lastname: Suarez
authors.forename: Ismael
authors.initials: I
authors.lastname: Gil
authors.forename: José Luis
authors.initials: JL
authors.lastname: Salcini
authors.forename: Manuel
authors.initials: M
authors.lastname: Lahoz
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: De Gregorio
mesh_terms: D000328:Adult; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology; D010535:Laparoscopy; D007813:Laparotomy / Q000009:adverse effects; D008297:Male; D008467:Meckel Diverticulum / Q000000981:diagnostic imaging / Q000601:surgery*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m; D000267:Tissue Adhesions / Q000209:etiology
chemical_list: D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m