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Full robotic Hartmann's reversal: technical aspects and preliminary experience
G Giuliani1, G Formisano1, M Milone2
1Department of Surgery, Unit of General and Minimally Invasive Surgery, Ospedale Misericordia, Grosseto, Italy.
Summary
Robotic Hartmann's reversal (HR) is a safe and feasible surgical option. This robotic approach demonstrated low complication and conversion rates in a series of 24 patients, suggesting it may increase HR accessibility.
Area of Science:
- Minimally Invasive Surgery
- Surgical Robotics
- Gastrointestinal Surgery
Background:
- Laparoscopic Hartmann's reversal (HR) is a complex procedure with significant risks.
- Robotic surgery offers potential advantages in overcoming laparoscopic challenges.
Purpose of the Study:
- To evaluate the short-term outcomes of robotic Hartmann's reversal (HR).
- To assess the feasibility and safety of robotic HR in a clinical setting.
Main Methods:
- Prospective data collection and retrospective analysis of 24 robotic HR cases.
- Standardized single-docking robotic procedure with intracorporeal anastomosis.
- Study conducted across two institutions between September 2016 and July 2019.
Main Results:
- The study included 24 patients (mean age 69 years, BMI 26 kg/m²), with 58% aged 70+ and 42% having comorbidities.
- Mean operative time was 240 minutes, with no conversions to open or laparoscopic surgery.
- Low morbidity observed: 6-day mean hospital stay, 3 minor complications, and no major complications or 30-day readmissions.
Conclusions:
- Robotic HR is a feasible and safe surgical procedure.
- The robotic approach is associated with low rates of major complications and conversion.
- Robotic HR may expand patient access to this restorative surgery.
