Name of the Procedure:

Unlisted procedure, Meckel's diverticulum and the mesentery

Summary

This procedure involves the surgical treatment of Meckel's diverticulum, which is a congenital malformation of the small intestine. The procedure addresses issues related to this abnormal pouch by removing it along with any affected mesentery (the tissue connecting the intestines to the abdominal wall).

Purpose

The procedure aims to resolve complications arising from Meckel's diverticulum, such as bleeding, obstruction, inflammation, or infection. The expected outcome is the alleviation of symptoms and prevention of future complications.

Indications

Symptoms warranting this procedure include:

• Abdominal pain
• Gastrointestinal bleeding
• Obstruction of the intestine
• Signs of diverticulitis (inflammation of the diverticulum) Criteria include confirmed diagnosis through imaging or endoscopic studies and failure of conservative treatments.

Preparation

• Fasting for 8-12 hours before the procedure.
• Adjustments to medications, particularly anticoagulants and antiplatelets.
• Preoperative blood tests, imaging studies, and potentially a colonoscopy to confirm diagnosis and plan the surgery.

Procedure Description

1. The patient is placed under general anesthesia.
2. A small incision is made in the abdomen or laparoscopic tools are inserted.
3. The surgeon locates the Meckel's diverticulum.
4. The diverticulum and any affected mesentery are carefully dissected and removed.
5. The small intestine is repaired by suturing or stapling the cut ends together.
6. The surgical site is checked for bleeding, and the incisions are closed.

Tools used include:

• Scalpel, laparoscopic instruments
• Staplers or suturing devices
• Surgical retractors

Duration

The procedure typically takes 1-2 hours.

Setting

The procedure is performed in a hospital's operating room, often within the surgical or gastrointestinal unit.

Personnel

The healthcare team includes:

• A general or gastrointestinal surgeon
• An anesthesiologist
• Surgical nurses
• Possibly a surgical technologist

Risks and Complications

Common risks:

• Infection
• Bleeding
• Bowel obstruction Rare risks:
• Injury to nearby organs
• Anastomotic leakage (where the intestine is reconnected) Complications can be managed with medication, further surgery, or other interventions.

Benefits

The primary benefit is the resolution of symptoms related to Meckel's diverticulum. Patients can expect improvement within days to a few weeks following the procedure.

Recovery

• Initial recovery involves a hospital stay of 2-5 days.
• Instructions include wound care, dietary modifications, and avoiding heavy lifting for 4-6 weeks.
• Follow-up appointments are essential to monitor healing and any signs of complications.

Alternatives

Alternative treatments may include:

• Conservative management with medications for symptoms.
• Endoscopic removal (less commonly performed). Each alternative varies in invasiveness, risk, and effectiveness compared to surgery.

Patient Experience

Patients may experience discomfort and pain initially, managed with prescribed analgesics. Post-surgery, they might feel bloated or have altered bowel habits temporarily, which typically improves as recovery progresses. Comfort measures include adequate pain control, early mobilization, and dietary adjustments.