Laparoscopic Reversal of Hartmann's Procedure

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What is Hartmann’'s procedure?

Hartmann’'s procedure involves removing a piece of large bowel (colon). It is usually performed as an emergency. The two ends of bowel were not joined together because your surgeon decided the risks were too high. Your surgeon made a colostomy (your large bowel opening onto your skin). The other end was closed as a rectal stump (see figure 1). Your surgeon has decided it is safe to join the two ends of your bowel back together.

What are the benefits of surgery?

You should be able to open your bowels in the normal way and you should no longer have a stoma bag.

What does the operation involve?

The operation is performed under a general anaesthetic and usually takes about 90 minutes to two hours.
Your surgeon will make several small cuts on your abdomen. They will insert surgical instruments, along with a telescope, inside your abdomen and perform the operation.
Your surgeon will join the two ends of your bowel back together and place your bowel inside your abdominal cavity.

What complications can happen?

1. General complications

  • Pain
  • Bleeding
  • Infection of the surgical site
  • Chest infection
  • Unsightly scarring
  • Developing a hernia in the scar
  • Blood clots

2. Specific complications

  • Damage to internal structures
  • Developing a hernia near one of the cuts
  • Surgical emphysema
  • Anastomotic leak
  • Continued bowel paralysis
  • Diarrhoea
  • Death

How soon will I recover?

It is usual for your bowel to stop working for a few days. You should be able to go home after 3 to 11 days.
It can take up to three months to return to normal activities.
Regular exercise should help you to return to your normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.
Most people make a good recovery.

Summary

Reversal of Hartmann’s procedure will allow you to open your bowels in the normal way. You will no longer need a stoma bag.

Acknowledgments

Author: Mr Jonathan Lund DM FRCS (Gen. Surg.), Illustrations: Medical Illustration Copyright © Medical-Artist.com

This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.