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VOLUME 15 , ISSUE 2 ( May-August, 2022 ) > List of Articles
Leesa Misra, Jyotirmaya Nayak, Manash Ranjan Sahoo, Soumya Bharati Rout
Keywords : Covidien EEA 31 mm circular stapler, Laparoscopic Hartmann reversal, Primary treatment modality
Citation Information : Misra L, Nayak J, Sahoo MR, Rout SB. Laparoscopic Reversal of Hartmann's Procedure as a Primary Treatment Modality: A Single-center Experience. World J Lap Surg 2022; 15 (2):182-184.
License: CC BY-NC 4.0
Published Online: 16-08-2022
Copyright Statement: Copyright © 2022; The Author(s).
Aim: The aim of this study is to evaluate the results of laparoscopic reversal of Hartmann's procedure assisted by transanal circular stapler as a primary treatment modality. Materials and methods: About 32 patients presenting with an end colostomy due to various elective and emergency surgical, gynecological, and obstetric indications were selected for this study, from April 2010 to March 2016. All the patients were subjected to ultrasonography of the abdomen and pelvis, a colostogram and contrast enema, and colonoscopy. Patients selected for the study were subjected to all routine workup. Pre-anesthetic evaluation was done. Parameters such as operative time, conversion rates, intraoperative blood loss, postoperative complications, return of bowel movements, starting on oral feed, anastomotic leak, port-site infection, and hospital stay were studied. Results: About 32 patients, including both male (12) and female (20), were included in the study. The age ranged between 30 years and 65 years (mean 47.5 years). The mean operative time was 150.6 ± 20.4 minutes. Four cases were converted to open. Oral feeds were started on 2 ± 1 postoperative day. Patients tolerated solid soft diet 96 hours after surgery. Postoperative hospital stay was 7 days (range 6–8 days). No patients had anastomotic leak or required revision surgery. Three patients had port-site infections. Conclusion: We conclude that transanal stapler-assisted laparoscopic Hartmann reversal can be considered as a primary modality of treatment in the hands of an experienced surgeon though having a steeper learning curve and a higher difficulty score compared with other laparoscopic colorectal surgeries with benefits of lesser intraoperative time, early return of bowel movements, faster initiation of oral solid feeds, decreased incidence of anastomosis leak, and lesser hospital stay.
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