Key Steps During Hartmann’s Procedures to Facilitate Minimally Invasive Hartmann’s Reversal

  • Alan E. HarzmanEmail author
  • Syed Husain


Minimally invasive (robotic or laparoscopic) closure of end stomas is a safe and viable option in the hands of experienced surgeons and appropriately selected patients. As in all planned two-part operations, the success of the second operation is greatly influenced by the first operation. This chapter focuses on aspects of the first operation that can be modified to make minimally invasive stoma closure more successful.


Colostomy Hartmann’s procedure Stoma Reversal Takedown Laparoscopic Robotic Minimally invasive 


  1. 1.
    Roig JV, Cantos M, Balciscueta Z, Uribe N, Espinosa J, Rosello V, et al. Hartmann’s operation: how often is it reversed and at what cost? A multicentre study. Color Dis. 2011;13(12):e396–402.CrossRefGoogle Scholar
  2. 2.
    Hallam S, Mothe BS, Tirumulaju R. Hartmann’s procedure, reversal and rate of stoma-free survival. Ann R Coll Surg Engl. 2018;100(4):301–7.CrossRefGoogle Scholar
  3. 3.
    Brathwaite S, Kuhrt M, Yu L, Arnold M, Husain S, Harzman AE. Retrospective evaluation of laparoscopic versus open Hartmann’s reversal: a single-institution experience. Surg Laparosc Endosc Percutan Tech. 2015;25(5):e156–8.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Arkenbosch J, Miyagaki H, Kumara HM, Yan X, Cekic V, Whelan RL. Efficacy of laparoscopic-assisted approach for reversal of Hartmann’s procedure: results from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Surg Endosc. 2015;29(8):2109–14.CrossRefGoogle Scholar
  5. 5.
    Brathwaite S, Latchana N, Esemuede I, Harzman A, Husain S. Risk factors for surgical site infection in open and laparoscopic Hartmann closure: a multivariate analysis. Surg Laparosc Endosc Percutan Tech. 2017;27(1):51–3.PubMedGoogle Scholar
  6. 6.
    Mais V. Peritoneal adhesions after laparoscopic gastrointestinal surgery. World J Gastroenterol. 2014;20(17):4917–25.CrossRefGoogle Scholar
  7. 7.
    Kumar S, Wong PF, Leaper DJ. Intra-peritoneal prophylactic agents for preventing adhesions and adhesive intestinal obstruction after non-gynaecological abdominal surgery. Cochrane Database Syst Rev. 2009;1:CD005080.Google Scholar
  8. 8.
    Metwally M, Watson A, Lilford R, Vandekerckhove P. Fluid and pharmacological agents for adhesion prevention after gynaecological surgery. Cochrane Database Syst Rev. 2006;2:CD001298.Google Scholar
  9. 9.
    Timmermans L, Deerenberg EB, Lamme B, Jeekel J, Lange JF. Parastomal hernia is an independent risk factor for incisional hernia in patients with end colostomy. Surgery. 2014;155(1):178–83.CrossRefGoogle Scholar

Copyright information

© Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2020

Authors and Affiliations

  1. 1.The Ohio State University, Department of SurgeryColumbusUSA
  2. 2.Ohio State University Wexner Medical Center, Division of Colon and Rectal SurgeryColumbusUSA

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