Single-port Laparoscopic Reversal of Hartmann's Procedure : Technique and Results

Abstract EN

In general, reversal of Hartmann's procedure is associated with a high morbidity and therefore leads to a low rate of intestinal restoration.

Reversal of Hartmann's procedure has to be seen as a complex abdominal operation with the same possible complications as in other colorectal resections.

By using the laparoscopic technique, operative access trauma by laparotomy can be minimized.

After introducing single-port access into laparoscopic surgery beginning with cholecystectomies and sigmoid resections, we started with the first single-port laparoscopic reversal of Hartmann's procedure in January 2010.

After excision of the colostoma, mobilization, and reponing into the abdominal cavity, the single-port trocar was placed at the stoma incision without any extra scar.

We investigated whether the single-port laparoscopic reversal is as safely feasible as the “conventional” laparoscopic procedure.

Till December 2010, single-port reversal operation was performed in 8 patients 2–4 months after Hartmann's procedure because of complicated diverticulitis.

No conversion to “conventional” laparoscopic or open procedure was necessary in 1 patient one extra 5 mm trocar was used.

The average operation time was 74 min.

Except for one wound complication, the postoperative course was uncomplicated.

The patients were discharged after 4 to 8 postoperative days.

Single-port reversal of Hartmann's procedure has showed as a new method for minimizing the access trauma even further than “conventional” laparoscopic surgery.