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Meckel’s diverticulectomy
Definition
Meckel's diverticulectomy is surgery to remove an abnormal pouch on the lining of the small intestine (bowel). This pouch is called a Meckel's diverticulum.
Description
You will receive general anesthesia before surgery. This will make you sleep and unable to feel pain.
- If you have open surgery, your surgeon will make a large surgical cut in the right side of your lower belly to open up the area.
- Your surgeon will examine the small intestine in the area where the pouch or diverticulum is located.
- Your surgeon will remove the diverticulum from the wall of your intestine.
- Sometimes, the surgeon may need to remove a small part of your intestine along with the diverticulum. If this is done, the open ends of your intestine will be sewn or stapled back together. This procedure is called anastomosis.
Surgeons can also do this surgery using a laparoscope. A laparoscope is a tiny camera that is inserted into your belly through a small cut. Video from the camera will appear on a monitor in the operating room. The surgeon uses the monitor to do the surgery. In surgery using a laparoscope:
- Your surgeon will make 3 to 5 small cuts in your belly. The camera and other small tools will be inserted through these cuts.
- Your surgeon may also make a cut that is 2 to 3 inches long to put a hand through, if needed.
- Your belly will be filled with gas to allow the surgeon to see the area and perform the surgery with more room to work.
Why the Procedure Is Performed
Treatment of Meckel’s diverticulum is needed to prevent:
- Bleeding
- Bowel obstruction (a blockage in your intestine)
- Infection
- Inflammation
The most common symptom of Meckel's diverticulum is painless bleeding from the rectum. Your stool may contain fresh blood or look black and tarry.
Most people have surgery to treat a Meckel’s diverticulum if it causes symptoms.
Risks
Risks for any anesthesia are:
- Allergic reactions to medicines
- Breathing problems
Risks for any surgery are:
- Bleeding
- Blood clots in the legs that may travel to the lungs
- Heart attack or stroke during surgery
- Infection
Risks for this surgery are:
- Damage to nearby organs in the body
- Wound infections or the wound breaks open after surgery
- Bulging tissue through the surgical cut. This is called an incisional hernia.
- The edges of your intestines that are sewn or stapled together (anastomosis) may come open. This may cause life-threatening problems.
- Scar tissue may form in your belly and cause a blockage in your intestines.
- Bowel obstruction may occur later from adhesions caused by the surgery
Before the Procedure
Always tell your doctor or nurse:
- If you are or could be pregnant
- What drugs you are taking, even drugs, supplements, or herbs you bought without a prescription
During the days before your surgery:
- You may be asked to stop taking drugs that make it hard for your blood to clot. Some of these are aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), and clopidogrel (Plavix).
- Ask your doctor which drugs you should still take on the day of the surgery.
- If you smoke, try to stop. Ask your doctor or nurse for help quitting.
On the day of your surgery:
- You will usually be asked not to drink or eat anything after midnight the night before the surgery.
- Take the drugs your doctor told you to take with a small sip of water.
- Your doctor or nurse will tell you when to arrive at the hospital.
After the Procedure
Most people stay in the hospital for 3 to 7 days if there are no problems after surgery. During this time:
- Doctors and nurses will carefully monitor you.
- You will receive medicine to relieve any pain.
You will receive fluids and nutrition through an IV (a tube that goes into a vein) at first. You will have this IV until your doctor or nurse can hear bowel sounds. These sounds mean your bowels are active again. Passing gas or having a bowel movement is a sign of bowel activity. Once this happens, you can starting eating by mouth.
You may have a tube through your nose into your stomach. This is called a nasogastric tube. It will empty your stomach and relieve the nausea and vomiting.
You may need to take antibiotics to prevent or treat an infection.
You will need to follow up with your surgeon 7 to 10 days after surgery for testing.
Outlook (Prognosis)
Most people who have a Meckel's diverticulectomy have a good outcome. But the results of any surgery depend on your overall health. Talk with your doctor about your expected outcome.
References
Evers BM. Small intestine. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 48.
Reviewed By: Shabir Bhimji MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
