title: Total laparoscopic reversal of Hartmann's procedure.
abstract: Hartmann's procedure is still performed in those cases in which colorectal anastomosis might be unsafe. Reversal of Hartmann's procedure (HR) is considered a major surgical procedure with a high morbidity (55 to 60%) and mortality rate (0 to 4%). To decrease these rates,  laparoscopic Hartmann's reversal procedure was successfully experienced. We report our totally laparoscopic Hartmann's reversal technique. Between 2004 and 2010 we performed 27 HRs with a totally laparoscopic approach. The efficacy and safety of this technique were demonstrated evaluating  the operative data, postoperative complications, and the outcome of the patients. There were no open conversions or major intraoperative complications. Anastomotic leaking occurred in one patient requiring an ileostomy; one patient needed a blood transfusion and one had a nosocomial pneumonia.  The mean postoperative hospitalization was 5.7 days. Laparoscopic HR is a feasible and safe procedure and can be considered a valid alternative to open HR.
authors: Department of Surgery, St. Andrea Hospital, School of Medicine and Psicology, University Sapienza of Rome, Rome, Italy.
authors: Luigi
authors: L
authors: Masoni
authors: Francesco Saverio
authors: FS
authors: Mari
authors: Giuseppe
authors: G
authors: Nigri
authors: Francesco
authors: F
authors: Favi
authors: Fioralba
authors: F
authors: Pindozzi
authors: Anna
authors: A
authors: Dall'Oglio
authors: Alessandra
authors: A
authors: Pancaldi
authors: Antonio
authors: A
authors: Brescia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D003106:Colon / Q000601:surgery*; D003125:Colostomy; D004239:Diverticulitis, Colonic / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012007:Rectum / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome