Background and Objective: Artificial intelligence (AI) is transforming the medical field, including pediatric surgery, by enhancing diagnostic precision, surgical planning, intraoperative guidance, and postoperative care. Despite the increasing interest, a comprehensive understanding of AI’s current applications and challenges in pediatric surgery is lacking. This narrative review aims to summarize current AI applications in pediatric surgery and evaluate their impact on clinical care, surgical training, and patient outcomes. Methods: A literature review was conducted in January 2025 using PubMed and Web of Science. The search terms were “artificial intelligence” and “pediatric surgery”, restricted to English-language articles published from 2015 to 2025. After excluding studies on adult populations and unrelated specialties, 46 articles were selected for analysis. Key Content and Findings: The reviewed literature demonstrates AI’s utility across the pediatric surgical spectrum. Most prominently, AI enhances diagnostic accuracy for conditions like appendicitis, necrotizing enterocolitis (NEC), Hirschsprung’s disease (HD) and biliary atresia. AI also supports surgical planning via three-dimensional (3D) modeling, augments intraoperative navigation and skill assessment, and improves postoperative care through complication prediction and pain evaluation. Furthermore, AI tools facilitate caregiver education and emotional support. Nevertheless, limitations remain, including pediatric data scarcity, variability in model reporting, and unresolved ethical and legal concerns. Conclusions: AI holds great potential for transforming pediatric surgical care by improving accuracy, efficiency, and personalization. Future research should focus on generating robust pediatric datasets, validating tools in clinical settings, and integrating ethical frameworks. AI-human collaboration could reshape pediatric surgery and contribute meaningfully to patient care and policy development.

Background: Meckel’s diverticulum on the mesenteric side has been reported only as case reports in the literature and presents a diagnostic challenge, with ultimate recognition often taking place intraoperatively. We describe a case series of children with mesenteric Meckel’s diverticulum (MMD) treated at our institution, along with the results of a systematic review of the literature. Methods: Our experience on MMD was analyzed along with a systematic literature review performed according to PRISMA criteria. We identified studies published from 1941 to 2023 from PubMed, EMBASE, SCOPUS, and WOS. Search terms were variations of “Meckel”, “diverticulum”, and “mesenteric”. Inclusion criteria were patients < 18 years of age and articles written in English. Results: A total of three cases of MMD were observed and treated in our hospital. The mean age was 7.6 years. The most common symptoms were rectal bleeding and abdominal pain. Diagnostic workup included ultrasound and both upper and lower endoscopy. Surgery was performed by the laparoscopy-assisted technique. One case had to be reoperated due to postoperative intestinal occlusion. The mean length of hospital stay was 9.3 days. The literature search yielded 795 citations; out of the 590 papers remaining after the exclusion of 205 duplications, only 15 papers matched the inclusion criteria and were included and analyzed. Conclusions: MMD remains a rare and elusive pathology, sharing with its normal counterpart symptoms and signs. In our experience, and in the more recent literature, laparoscopy-assisted surgery appears safe and effective both for final diagnosis and definitive treatment.