Definition

Meckel diverticulectomy is surgery to remove an abnormal pouch of the lining of the small intestine (bowel). This pouch is called a Meckel diverticulum.

Alternative Names

Meckel diverticulectomy; Meckel diverticulum - surgery; Meckel diverticulum - repair; GI bleeding - Meckel diverticulectomy; Gastrointestinal bleeding - Meckel diverticulectomy

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 your belly to open up the area.
• Your surgeon will look at 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 an anastomosis.

Surgeons can also do this surgery using a laparoscope. The laparoscope is an instrument that looks like a small telescope with a light and a video camera. It is inserted into your belly through a small cut. Video from the camera appears on a monitor in the operating room. This allows the surgeon to view inside your belly during surgery.

In surgery using a laparoscope:

• Three to five small cuts are made 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 (5 to 7.6 cm) 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.
• The diverticulum is operated on as described above.

Why the Procedure Is Performed

Treatment is needed to prevent:

• Bleeding
• Bowel obstruction (a blockage in your intestine)
• Infection
• Inflammation

The most common symptom of Meckel diverticulum is painless bleeding from the rectum. Your stool may contain fresh blood or look black and tarry.

Risks

Risks for anesthesia and surgery in general are:

• Allergic reactions to medicines or breathing problems
• Bleeding, blood clots, or 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.
• The area where the intestines are sewn together can scar and create blockage of the intestine.
• Blockage of the intestine may occur later from adhesions caused by the surgery.

Before the Procedure

Tell your surgeon:

• If you are or could be pregnant
• What medicines you are taking, even medicines, supplements, or herbs you bought without a prescription

During the days before your surgery:

• You may be asked to stop taking blood thinners. These include NSAIDs (aspirin, ibuprofen), vitamin E, warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), 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 health care provider for help quitting.

On the day of your surgery:

• Follow your doctor's instructions about when to stop eating and drinking.
• Take the medicines you were told to take with a small sip of water.
• Arrive at the hospital on time.

After the Procedure

Many people stay in the hospital for 1 to 7 days depending on how extensive the surgery was. During this time, the provider will carefully monitor you.

Treatment may include:

• Pain medicines
• Tube through your nose into your stomach to empty your stomach and relieve nausea and vomiting

You will also be given fluids through a vein (IV) until your provider feels you are ready to start drinking or eating. This could be as soon as the day after surgery.

You will need to follow-up with your surgeon in a week or two after surgery.

Outlook (Prognosis)

Many people who have this surgery have a good outcome. But the results of any surgery depend on your overall health. Talk with your doctor about your expected outcome.

References

Fransman RB, Harmon JW. Management of diverticulosis of the small bowel. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:143-145.

Gan T, Evers BM. Small intestine. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis MO: Elsevier; 2022:chap 50.