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Single-incision laparoscopic reversal of Hartmann procedure via the colostomy site only: first report
Brian M Smith1, David A Bettinger
1Department of Surgery, CJW Medical Center, Richmond, VA, USA. smithbr@thesar.com
Background:
Transumbilical single-incision laparoscopic surgery (SILS) provides an alternative to traditional multiport laparoscopic surgery. The technique may also avoid some of the difficulties surrounding laparoscopic Hartmann reversal. This case represents the first SILS Hartmann reversal via the colostomy site.
Methods:
SILS Hartmann reversal was performed in a 56-year-old man with a history of resection for perforated diverticulitis. The procedure was performed via a single port placed into the former colostomy site. A combination of flexible and straight instruments was used.
Results:
The procedure was completed successfully with an operative time of 104 minutes. Recovery was uneventful, and the patient was discharged on postoperative day 5, with no complaints at follow-up.
Conclusion:
SILS Hartmann procedure reversal via the colostomy site is safe. The approach avoids additional incisions and allows avoidance of dense adhesions to the previous midline incision--a new benefit of SILS, apart from cosmesis.
