Meckel’s Diverticulectomy

Procedure Snapshot

• Indication: Symptomatic Meckel’s diverticulum (bleeding, obstruction, diverticulitis).
• Expected duration: ___
• Special instruments: Linear stapler, Babcock, bowel clamps.

Step Workflow

1. Midline or laparoscopic exploration.
2. Identify diverticulum ~60 cm from ileocecal valve.
3. Wedge stapled resection of diverticulum (base flush with ileum).
4. Inspect mucosa for ectopic gastric tissue.
5. Leak test; close mesenteric defect.

Key Pimp Questions

• Q: Rule of 2’s? A: 2% prevalence, 2 inches long, 2 feet from ICV, 2% symptomatic.
• Q: Most common ectopic tissue? A: Gastric (60–85%).

Critical Anatomy

• Landmarks: Ileocecal junction, mesentery.
• Danger zones: Mesenteric vessels.

Informed Consent Highlights

• Bleeding, leak, adhesive SBO.

Post-op Considerations

• Early diet advance if non-perforated.

References

• Chassin’s, Small Bowel chapter. Clinical Scenarios, Pediatric/General.
• Malik 2019 (PMID 30999513).