Laparoscopic Reversal of Hartmann's Procedure.

, Kim, Jin; , Kim, Seon Hahn; , Lee, Eun Sook; , Moon, Hong Young; , Koo, Bum Hwan

Original Article

Journal of the Korean Society of Coloproctology 1998;14(1):137-142.

Kim, Jin , Kim, Seon Hahn , Lee, Eun Sook , Moon, Hong Young , Koo, Bum Hwan

Abstract

We report herein our surgical experience of Hartmann's procedure reversal using laparoscopic technique in a 72-year-old woman who underwent Hartmann's procedure for an obstructing sigmoid colon cancer 6 month earlier. The purposes of this report are to describe our technique of laparoscopic reversal of Hartmann's procedure, to introduce several technical tips in avoiding pitfalls, and to review its safty and efficacy. In brief, the colostomy was freed from the abdominal wall using a conventional technique, then a center rod and an anvil of a circular stapler were inserted into the colon. CO2 insufflation was performed through this insertion. Using a five-cannula technique, rectal stump was mobilized, then colorectal anastomosis was performed laparoscopically via a transanal stapled approach. The operating time was 130 minutes and blood loss was 50 ml. There were no intra- and postoperative complications. Up to now, with a 4-month follow-up period, the patient has been well without having any problems associated with this operation