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Laparoscopy-assisted trans-umbilical Meckel's diverticulectomy described in pediatric case seriesCan a small keyhole surgery safely fix a rare gut blockage in children?

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Key Takeaway
Consider LATUM as a described technique for pediatric Meckel's diverticulum with internal hernia, but evidence is limited to small case series.

This case series and narrative literature review examined laparoscopy-assisted trans-umbilical Meckel's diverticulectomy (LATUM) in pediatric patients with Meckel's diverticulum complicated by internal hernia. The analysis included 3 consecutive pediatric cases (median age 7 years, range 7-11) from the authors' institution and 25 cases identified through literature review. No comparator group was reported.

In the 3-case series, LATUM was completed without conversion to open surgery. Median operative time was 65 minutes, estimated blood loss was 10 mL, time to first flatus was 24 hours, and hospital stay was 7.5 days. No complications occurred during a median follow-up of 16 months. The literature review of 25 cases found that 9 cases (32.14%) used LATUM, 8 cases (28.57%) used open resection, and 11 cases (39.29%) did not describe the surgical approach.

Safety data from the case series showed no reported complications, adverse events, or discontinuations. Tolerability was not reported. Key limitations include the retrospective, uncontrolled design; small sample size; and lack of comparative effectiveness data. The literature review component was narrative rather than systematic. Funding sources and conflicts of interest were not reported.

For practice, this report describes a surgical technique option in a specific pediatric complication scenario. The authors suggest LATUM may offer a minimally invasive approach, but the evidence remains preliminary. Clinical decisions should be based on individual patient factors and surgeon experience, as no comparative data on outcomes versus standard approaches are presented.

Imagine a child with a rare internal blockage in their intestine caused by a small pouch called Meckel's diverticulum. This condition is tricky because the bowel can twist inside itself, cutting off blood flow. If not caught early, the tissue dies. Three children, aged seven to eleven, faced this danger. Their doctors used a laparoscopy-assisted trans-umbilical Meckel's diverticulectomy, or LATUM. This method uses small cameras and tools to remove the pouch through a tiny opening near the belly button.

During the procedure, the team worked quickly. The average time in the operating room was 65 minutes. Very little blood was lost, and the children started passing gas again within 24 hours. They stayed in the hospital for about a week and a half before going home. Crucially, none of these three children experienced any complications during their recovery or follow-up visits.

When looking at other similar cases in medical reports, doctors found that LATUM was used in about one-third of those situations. However, many older reports did not specify exactly how the surgery was done. This study shows that LATUM is a safe and less invasive option for kids. But because this is based on just three patients and a review of stories, it is not yet enough to say this should be the only way to treat everyone. More data is needed to be sure.

What this means for you:
This small study suggests a keyhole surgery is safe for children with this rare blockage, but larger groups are needed to confirm it.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
Meckel's diverticulum (MD) is the most prevalent congenital anomaly of the small intestine. Internal hernia secondary to MD is extremely rare in children and poses a diagnostic and therapeutic challenge. We report three consecutive paediatric cases successfully managed by laparoscopy-assisted trans-umbilical Meckel's diverticulectomy (LATUM) and provide a comprehensive review of the world literature. Clinical data of three children with MD complicated by internal hernia treated between March 2023 and April 2024 were retrospectively analysed. A systematic search of PubMed, Web of Science and Google (up to June 2025) was performed to identify previously published paediatric cases. Two boys and one girl (median age: 7 years, range: 7–11) presented with acute abdominal pain and vomiting. Pre-operative imaging suggested intestinal obstruction or intussusception. Laparoscopy revealed internal hernia formed by a mesodiverticular band (MDB) in all cases. LATUM was completed without conversion. Median operative time was 65 min (range: 50–90, IQR: 55–75), estimated blood loss was 10 mL (range: 5–15, IQR: 7.5–12.5), and time to first flatus was 24 h (range 18–36, IQR 20–30). Median hospital stay was 7.5 days (7–8). No complications occurred during a median follow-up of 16 months. The literature review yielded 25 additional paediatric cases. Including our series, 28 children have been reported; 9 cases (32.14%) used LATUM, 8 cases (28.57%) used open resection, and 11 cases (39.29%) did not describe the surgical approach. LATUM offers a safe, minimally invasive and cosmetically superior option for children with MD complicated by internal hernia. A high index of suspicion and early laparoscopy are crucial to avoid bowel necrosis.
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