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Case Reports
. 2012 Apr;82(4):256-60.
doi: 10.4174/jkss.2012.82.4.256. Epub 2012 Mar 27.

Laparoscopic reversal of Hartmann's procedure

Joong-Min Park  1 , Kyong-Choun Chi
Affiliations
Case Reports

Laparoscopic reversal of Hartmann's procedure

Joong-Min Park et al. J Korean Surg Soc. 2012 Apr.

Abstract

Reversal of Hartmann's procedure is a major surgical procedure associated with significant morbidity and mortality. Because of the difficulty of the procedure, laparoscopic reversal of Hartmann's procedure is not well established. We describe our experience with this laparoscopic procedure to assess its difficulty and safety. Five patients (4 men and 1 woman) underwent laparoscopic reversal of Hartmann's procedure (LRHP). The initial surgeries were performed to manage obstructive colorectal cancer for 4 patients, and rectovesical fistula for one patient. The procedure was laparoscopically completed for 4 patients. Conversion to open laparotomy was required for one patient, secondary to massive adhesion in lower abdomen. Transient ileostomies were made in 2 cases. Operative time ranged from 240 to 545 minutes. There was no operative mortality. LRHP can be performed safely by an experienced surgeon. However, it is still technically challenging and time consuming.

Keywords: Colostomy; Hartmann's procedure; Laparoscopy.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Laparoscopic view of the colostomy.
Fig. 2
Fig. 2
Mobilization of the left colon and splenic flexure. S, spleen; C, descending colon.
Fig. 3
Fig. 3
Laparoscopic view of rectal stump after pelvic adhesiolysis. R, rectal stump; SB, small bowel.
Fig. 4
Fig. 4
End-to-end anastomosis with a circular stapling device. PC, proximal colon.
See this image and copyright information in PMC

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