Single-port laparoscopic reversal of Hartmann's procedure via the colostomy site

Abstract

Background: The aim of this study was to report our initial experience with single-port laparoscopic reversal of Hartmann's procedure (SP-LHR).

Methods: Between December 2009 and March 2014, 23 patients underwent single-port laparoscopic reversal of Hartmann's procedure. Single-port laparoscopic surgeries (SPLS) were performed through the preexisting stoma site. A commercially available single port with one 5 mm and two 12 mm trocars was used with conventional straight and rigid laparoscopic instruments. Patient demographics and operative and postoperative outcomes were analyzed.

Results: SP-LHR was successful in 22 patients. No additional incisions for trocars or conversions to open surgery were necessary. In 1 patient, the procedure was aborted. The median operative time and postoperative length of stay were 165 min (range, 100-340 min) and 8 days (range, 4-31 days), respectively. The median time to the resumption of oral intake was 3 days (range, 1-16 days). No intraoperative complications were noted; there were four postoperative complications including one anastomotic leak.

Conclusions: In our experience, SP-LHR via the colostomy site was safe and feasible, and may be considered an additional surgical option for experienced SPLS surgeons in selected patients.

Keywords: Laparoscopy; Reversal of Hartmann's procedure; Single-port.