The suspended ileal loop for difficult Hartmann's reversal

Area of Science:

• Colorectal surgery
• Surgical techniques
• Gastrointestinal reconstruction

Background:

• Hartmann's reversal is often complicated by dense adhesions and risks of splenic or vascular injury.
• Challenges include freeing the splenic flexure and ensuring adequate colonic length.
• Potential complications like ureteral lesions also exist.

Purpose of the Study:

• To present a technique for restoring intestinal continuity in challenging Hartmann's reversal cases.
• To evaluate the utility of an interposed ileal loop in such scenarios.

Main Methods:

• A technique involving interposing an adapted ileal loop segment between the proximal colon and rectum is proposed.
• This method aims to restore intestinal continuity.

Main Results:

• The technique was successfully applied in two patients with complex indications for Hartmann's procedure.
• Both patients experienced uneventful recovery and satisfactory functional outcomes.
• The suspended ileal loop served as a salvage procedure.

Conclusions:

• A suspended ileal loop is a viable salvage option for potentially difficult Hartmann's reversal.
• This technique can be beneficial when standard reversal is anticipated to be challenging.