Robotic Single-Port Trans-stomal Hartmann Reversal
Antonino Spinelli1,2, Matteo Sacchi2, Ahmed M Chaoui2
1Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Diseases of the Colon and Rectum
|July 16, 2026
Summary
Robotic single-port Hartmann reversal offers a safe, scar-sparing alternative for restoring bowel continuity. This minimally invasive technique enhances visualization and instrument control, overcoming challenges of traditional laparoscopic surgery.
Area of Science:
- Colorectal surgery
- Minimally invasive surgery
- Robotic surgery
Background:
- The colostomy site offers natural access for scar-sparing Hartmann reversal.
- Single-incision laparoscopic surgery (SILS) presents technical challenges for this procedure.
- The da Vinci SP robotic platform may overcome SILS limitations with enhanced visualization and wristed instruments.
Purpose of the Study:
- To evaluate the feasibility and safety of a fully robotic single-port approach for Hartmann reversal.
- To assess the benefits of robotic assistance in overcoming technical limitations of SILS for this procedure.
Main Methods:
- A peristomal incision was used to mobilize the colonic stump and place a stapler anvil.
- The da Vinci SP single-port robot was docked for the procedure.
- Mobilization of the colon and rectal stump was performed to achieve a tension-free anastomosis.
Main Results:
- The study included 5 patients (3 women, 2 men) with a mean age of 57 years.
- Mean operating time was 199 minutes, with no additional ports required.
- No intraoperative or major postoperative complications occurred; mean hospital stay was 4 days.
Conclusions:
- Fully robotic single-port Hartmann reversal is a feasible and safe option for restoring bowel continuity.
- This approach minimizes adhesiolysis, reducing tissue trauma and enteric injury risk.
- The robotic platform improves visualization and instrument control, facilitating complex colorectal reconstructions.