Laparoscopic reversal of Hartmann's procedure: technique and results

Surg Laparosc Endosc Percutan Tech. 2008 Feb;18(1):24-8. doi: 10.1097/SLE.0b013e31815b3233.

Abstract

Reversal of Hartmann's procedure is associated with a high morbidity and mortality leading to a low rate of intestinal restoration. We investigated whether the laparoscopic reversal is safely feasible and offers any advantage to the patient. The reversal operation was performed in 28 of 34 patients after Hartmann's procedure. The laparoscopic reversal of Hartmann's procedure had a short operative time (69 min) and a conversion rate of 17.9%. Wound complications occurred in 10.7%, an anastomosic leak in 1 patient (3.6%). On average the patients were discharged after 8.6 (6 to 17) postoperative days. We conclude that the laparoscopic reversal of Hartmann's procedure is a technically demanding but feasible operation with a low postoperative morbidity and mortality. We recommend the laparoscopic approach, which could be favorable compared with historical open series.

MeSH terms

  • Adult
  • Anastomosis, Surgical / instrumentation
  • Anastomosis, Surgical / methods
  • Colon / surgery*
  • Colostomy
  • Endoscopy, Gastrointestinal / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Rectum / surgery*
  • Time Factors