What Is a Meckel’s Diverticulectomy?
A Meckel’s diverticulectomy is a surgical procedure done to remove a small pouch from the lining of the small intestine. This pouch is a birth defect called the Meckel’s diverticulum.
The Cleveland Clinic reports that Meckel’s diverticulum affects about 2 to 3 percent of people. This birth defect is a small pouch found in the lining of the small intestine. It can be between 1 and 12 centimeters in length. Most cases of Meckel’s diverticulum never cause symptoms and don’t require repair. Moreover, if symptoms of a Meckel’s diverticulum do occur, it often happens before the age of 2.
The most common symptom is painless bleeding or hemorrhage from the rectum. If this occurs, a Meckel’s diverticulectomy may be needed to repair it. Other symptoms that may require this procedure include bowel obstruction and inflammation or infection of the pouch. These issues often lead to significant abdominal pain without diarrhea or vomiting.
A surgeon will perform the procedure while you’re under a general anesthetic. This means that you’ll be in a deep sleep and won’t feel pain during the operation. After the surgery is over, you’ll spend a few days to a week in the hospital.
A surgeon will perform the procedure in an operating room at a hospital. When you check in, a you’ll be escorted to the area used to prepare patients for surgery. You’ll 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’ll feel a pinch when the needle pierces your skin.
Your surgeon and your anesthesiologist will do a quick physical exam. An anesthesiologist is a doctor who administers the anesthetic and monitors you while you sleep. If you’re anxious, the anesthesiologist may inject a sedative into your IV to help you relax.
Technicians will then bring 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 enters your body. Within a few seconds, you’ll fall asleep.
Doctors prefer to use laparoscopic surgery to perform a Meckel’s diverticulectomy. Laparoscopic surgery is a minimally invasive procedure in which your doctor uses a laparoscope, which is a thin, flexible tube with a camera. Your surgeon will insert the laparoscope through small incisions, or cuts, in your abdomen. Carbon dioxide gas is usually used to fill up and expand the abdomen so your surgeon can visualize organs and tissues better. The carbon dioxide gas is removed after the surgery is done.
Open surgery, on the other hand, requires a large abdominal incision. It may be necessary if the diverticulum is too inflamed or infected for your surgeon to remove it 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, they may need to remove a portion of the small intestine if intestinal tissues also show signs of inflammation or infection. They’ll then stitch the remaining healthy tissues together. This process is known as an anastomosis.
You’ll wake up from surgery in the recovery room. The staff will monitor your vital signs and give you pain medicine. When they’re sure you are stable, they’ll transfer you to a regular hospital room.
Your doctor will order pain medication as needed. You may also need intravenous or oral antibiotics if you had an infected Meckel’s diverticulum. Because the bowels tend to be less active shortly after surgery, you’ll receive nutrients through an IV until you’re able to pass gas and defecate.
Depending on 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 after you go home. For instance, they may tell you not to lift any heavy objects or carry out certain household tasks such as vacuuming.
You’ll see your surgeon again about a week after discharge to ensure you’re making a good recovery.
As with any medical procedure, there are risks. The anesthesia may cause an allergic reaction or breathing problems.
The risks for any surgery include:
- blood clots
- a heart attack
- a stroke
- an infection
This surgery usually has a positive outcome, meaning an end to pain, obstruction, and infection. The most common complications are bleeding and infection around the incision sites and scarring inside the abdomen.
Breakdown of the Anastomosis
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, which is the membrane that lines the organs of the abdomen that may result from infection. Sepsis is a condition in which the body has a severe response to an infection. Hypotension, which is low blood pressure, shock, and even death can occur.
Breakdown of the anastomosis is rare. Surgery can usually treat this if it’s detected early.