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The suspended ileal loop for difficult Hartmann’s reversal

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Techniques in Coloproctology Aims and scope Submit manuscript

Abstract

Background

Hartmann’s reversal can be complicated by the presence of dense adhesions in the upper part of the abdominal cavity, difficulties in freeing the splenic flexure with the risk of splenic tears, a lack of sufficient colonic length, the risk of ureteral lesion, or the risk of lesions of the vascular arcade.

Methods

We propose a technique which consists of interposing an adapted segment of ileal loop between the end of the proximal colon and the rectum to restore intestinal continuity.

Results

Two patients had Hartmann procedure, the first for a Hinchey stage 4 perforated diverticulitis and the second for a colorectal fistula due to ischemia of the proximal colonic segment. Hartmann’s reversal was expected to be difficult, so a suspended ileal loop was used. The outcomes were uneventful, and functional results were satisfactory.

Conclusions

A suspended ileal loop could be used as a salvage procedure in some cases of potentially difficult Hartmann’s reversal.

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Author information

Authors and Affiliations

  1. Department of Surgery, Sainte-Marie Private Hospital, 71100, Chalon-Sur-Saône, France

    P. Fernoux & E. Delorme

  2. Colorectal Unit, Department of Surgery, Grenoble Alpes University Hospital, CS 10 217, 38 043, 38000, Grenoble, France

    A. Foote & J. L. Faucheron

  3. University Grenoble Alps, UMR 5525, CNRS, TIMC-IMAG, 38000, Grenoble, France

    J. L. Faucheron

Authors
  1. P. Fernoux
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  2. E. Delorme
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  3. A. Foote
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  4. J. L. Faucheron
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Corresponding author

Correspondence to J. L. Faucheron.

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Conflict of interest

The authors declare that they have no conflict of interest exists.

Ethical approval

The study has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

For this type of study French law does not require formal consent. The patients consented that data about their surgery and follow up could be used and published in the context of clinical research.

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Fernoux, P., Delorme, E., Foote, A. et al. The suspended ileal loop for difficult Hartmann’s reversal. Tech Coloproctol 27, 243–246 (2023). https://doi.org/10.1007/s10151-022-02715-9

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  • DOI: https://doi.org/10.1007/s10151-022-02715-9

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