A Meckel’s diverticulectomy is a surgical procedure used to remove a small pouch—a birth defect called Meckel’s diverticulum—from the lining of the small intestine.
According to Medscape, a Meckel’s diverticulum is one of the most common birth defects. It affects about two percent of the population (Medscape, 2012). It is a small pouch found in the lining of the small intestine. This pouch measures 1 to 12 centimeters in length. Most cases of Meckel’s diverticulum never cause symptoms and don’t require repair.
The most common symptom is painless bleeding or hemorrhage from the rectum. This may require a Meckel’s diverticulectomy to be performed. Other symptoms that may require this procedure include bowel obstruction and inflammation or infection of the pouch.
A surgeon will perform the procedure while you are under a general anesthetic. This means that you will be in a deep sleep and will not feel pain during the operation. After the surgery is over, you will spend a few days to a week in the hospital.
Your procedure will be performed by a surgeon in an operating room at a hospital. When you check in, a nurse will escort you to the area used to prepare patients for surgery. You will exchange your clothes for a hospital gown. The nurse will check your vital signs and start an IV in your hand, wrist, or arm. You will feel a pinch when the needle pierces the skin.
Your surgeon and your anesthesiologist (doctor who will administer the anesthetic and monitor you while you sleep) will do a quick physical exam. If you are anxious, the anesthesiologist may inject a sedative into your IV to help you relax.
Technicians will then wheel you into the operating room on a gurney. The anesthesiologist will administer the anesthetic through your IV. You might feel a cold or stinging sensation when the drug is injected. Within a few seconds, you will fall asleep.
Doctors prefer to use laparoscopic surgery to perform the Meckel’s diverticulectomy. Laparoscopic surgery is considered a minimally invasive procedure. It is performed with the use of a laparoscope, a thin, flexible tube with a camera. the laparoscope is inserted into small incisions, or cuts, in your abdomen. This allows the surgeon to see what he or she is doing and perform the surgical procedure without open surgery.
Open surgery, on the other hand, requires a large abdominal incision. It may be used if the diverticulum is too inflamed or infected to be removed through a small incision. Doctors may also have to use open surgery if you have internal scars from earlier surgeries.
The surgeon can normally remove the pouch without damaging the small intestine. However, the doctors may need to remove a portion of the small intestine if intestinal tissues also show signs of inflammation or infection. The remaining healthy tissues are stitched together. This process is called anastomosis.
You will awake from surgery in the recovery room. The staff will monitor your vital signs and give you pain medicine. When they are sure you are stable, they will transfer you to a regular hospital room.
Your doctor will order pain medication as needed. He or she may also place you on IV or oral antibiotics if the Meckel’s diverticulum was infected. Because the bowels tend to stop working for a short time after abdominal surgery, you will receive nutrients through an IV until you are able to pass gas and defecate.
Depending upon the type of surgery and any complications that occur afterward, you can expect to stay in the hospital for a few days to a week. Your doctor will tell you how to care for yourself once you are discharged. For instance he or she may tell you not to lift any heavy objects or carry out certain household tasks such as vacuuming.
You will see your surgeon again about a week after discharge to ensure you are making a good recovery.
As with any medical procedure, there are risks. The anesthesia may cause allergic reaction or breathing problems.
The risks for any surgery include:
- blood clots
- heart attack or stroke
This surgery usually has a positive outcome, meaning an end to pain, obstruction, and infection. However, about 10 to 12 percent of patients who undergo a Meckel’s diverticulectomy develop complications ranging from mild to life-threatening (Medscape, 2011). The most common complications are bleeding and infection around the incision site(s) and scarring inside the abdomen.
A more serious complication is the breakdown of the anastomosis, resulting in an opening in the small intestine, spillage of the contents, and contamination of the abdominal cavity. This series of events can lead to peritonitis and sepsis.
Peritonitis is an inflammation of the peritoneum, the membrane that lines the abdomen. Sepsis is a condition in which the body has a severe response to an infection and symptoms of hypotension, low blood pressure, and shock can occur.
Breakdown of the anastomosis is rare and can usually be treated with surgery to reinforce the anastomosis, if recognized in time.