Strategy and technique for colostomy reversal by laparoscopy after left colectomy with end colostomy (Hartmann procedure)
Résumé
Hartmann's procedure is a simplified surgical procedure for left colonic resection used mainly in emergency situations in order to reduce postoperative morbidity and mortality. Depending on the underlying pathology and the general condition of the patient, the Hartmann procedure is carried out with the intention to restore intestinal at a later date (which is feasible in 32 to 85% of cases) with postoperative morbidity of 3-50% and mortality of 0-7.1%, respectively [1,2]. Although in the majority of cases, the initial intervention is performed by laparotomy, it has been shown that Hartmann reversal (HR), the procedure to restore intestinal continuity, can be performed laparoscopically in 78 to 100% of cases [3]. This approach has been associated with benefits in terms of reduced postoperative morbidity, duration of hospital stay, postoperative ileus and parietal infections [3-5].