Laparoscopically assisted reversal of Hartmann's procedure revisited.

ABSTRACT

Reversal of Hartmann's procedure is a major operation, associated with substantial morbidity and mortality. In light of this, many patients elect not to undergo reversal (44-49%). In recent years, enthusiasm for laparoscopic reversal of Hartmann's procedure has increased, with the outcomes of many series suggesting that it has a reduced morbidity and mortality compared with the open procedure. We present our initial experience of four cases of laparoscopically assisted reversal of Hartmann's procedure and review the literature on this technique. Laparoscopic reversal was successful in all but one case. Literature review shows reduced postoperative hospital stay compared with the traditional, open approach and suggests that laparoscopic reversal is associated with lower morbidity and mortality rates. Laparoscopic reversal of Hartmann's procedure is feasible with potential advantages for the patient.