Single-Incision Laparoscopic Reversal of Hartmann Procedure via the Colostomy Site Only

Smith, Brian M.; Bettinger, David A.

doi:10.1177/1553350611415425

Cited by 15 publications

(20 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A review of the literature reveals that only a few small case series have been published on this technique. At the moment no randomized controlled trials were published [37][38][39][40][41][42]. Table 5 summarizes the results of the available literature.…”

Section: Appraisal Of the Literaturementioning

confidence: 99%

See 1 more Smart Citation

The Evolution of Minimally Invasive Techniques in Restoration of Colonic Continuity

Clermonts¹,

Stassen²,

Zimmerman³

2017

Laparoscopic Surgery

View full text Add to dashboard Cite

Restoration of bowel continuity after Hartmann's procedure is considered technically challenging and is associated with high morbidity and mortality. This is the main reason why restoration of intestinal continuity is often not attempted. Over the past decade, considerable international experience has gained on this topic with new minimally invasive techniques being developed. This review details the evolution of minimally invasive techniques in restoration of colonic continuity after Hartmann's procedure. A comprehensive search of PubMed and Embase was done. Different restoration modalities were included. Eight studies, from six different countries, in which multiport laparoscopic restoration of continuity was compared to conventional open restoration of bowel continuity, were included. In the total of 254 patients, continuity was restored laparoscopically compared with 255 patients in which continuity was performed in open fashion. Restoration of bowel continuity via trephine access was also reported; three studies including 37 patients were included in this review. Single-port restoration of bowel continuity after Hartmann's procedure is a natural evolution of multiport laparoscopy and trephine access. Six studies reporting on single-port reversal of Hartmann's procedure were included with a total of 75 patients. Single-port access in combination with a transanal approach has also been reported; however, data are extremely limited as there is only one study in the published literature. Success of restoration of bowel continuity with less morbidity and mortality has been demonstrated throughout the evolution of the different surgical techniques. In this review advantages of different approaches for restoration of bowel continuity after Hartmann's procedure are discussed. Furthermore, surgical techniques are described, pictorial guides are added for some techniques, and flowcharts are given for easy use during clinical decision-making.

show abstract

Section: Appraisal Of the Literaturementioning

confidence: 99%

“…Table 5 summarizes the results of the available literature. The technique was first described by Smith and colleagues [42]; in this case single-port restoration of the intestinal continuity was performed in a 56-year-old patient with a history of perforated diverticulosis. Their total operation time was 104 min.…”

Section: Appraisal Of the Literaturementioning

confidence: 99%

The Evolution of Minimally Invasive Techniques in Restoration of Colonic Continuity

Clermonts¹,

Stassen²,

Zimmerman³

2017

Laparoscopic Surgery

View full text Add to dashboard Cite

show abstract

“…Conventional multiport laparoscopic (CL) RoH appears to have less morbidity than open surgery (OS) RoH [10][11][12][13], although there is a paucity of randomized data. The technique of single-incision laparoscopic (SIL) RoH through the stoma site was first reported in 2011 [14][15][16]. There was an obvious cosmetic benefit with favourable results in terms of short-term morbidity and outcomes.…”

Section: Introductionmentioning

confidence: 99%

Single‐incision laparoscopic reversal of Hartmann's operation through the stoma site: comparative outcomes with conventional laparoscopic and open surgery

et al. 2019

View full text Add to dashboard Cite

Aim Restoration of bowel continuity after Hartmann's procedure (RoH) can be challenging and associated with considerable morbidity. A technique using single-incision laparoscopic surgery through the stoma site (SIL RoH) has been shown to be feasible and safe. In this study, we compared clinical outcomes of SIL RoH with conventional laparoscopic surgery (CL) and open surgery (OS).Methods This was a retrospective analysis of a prospectively maintained database between 2007 and 2017 in a UK colorectal unit. The access technique was decided by the surgeon on a case by case basis.Results A total of 106 patients underwent RoH. It was carried out for diverticular disease (n = 71, 67.6%), cancer (n = 19, 17.9%) and anastomotic leak (n = 4, 3.8%). The remainder (n = 12, 11.3%) were for miscellaneous reasons including trauma. Most RoHs were performed via OS (n = 87, 81.1%). The most common intended approaches for RoH were SIL (n = 56, 52.8%) and OS (n = 34, 32.1%) with fewer starting with CL (n = 16, 15.1%). Conversion to OS took place in five (8.9%) patients with SIL and six (37.5%) with CL (P = 0.005). Postoperative complications occurred in 17 (30.4%) for SIL, seven (43.8%) for CL and 17 (50.0%) for OS (P = 0.162). Median operating time for SIL was 146 min (range 44-389), 211 min (109-320) for CL and 211 min (85-420) for OS (P < 0.001). Median length of stay was 4 days (2-44) for SIL compared to 6 (3-34) for CL and 7 (4-34) for OS (P < 0.001). Discharge on or before day 5 was achieved in 41 (74.5%) patients for SIL compared to six (37.5%) for CL and seven (20.6%) for OS (P < 0.001).Conclusion Compared to OS and CL, SIL RoH appears to have shorter operating times and hospitalization, with no discernible difference in morbidity; this finding requires further evaluation in a randomized setting.Keywords Single-incision laparoscopic surgery, laparoscopic surgery, single-port laparoscopic surgery, reversal of Hartmann's procedure What does this paper add to the literature? There is little evidence for the efficacy and benefits of single-incision laparoscopic surgery for the reversal of Hartmann's procedure, but this study suggests potential better short-term clinical outcomes over conventional laparoscopic and open surgery. We believe that a prospective randomized control trial would add further support for adoption of this technique.

show abstract

“…Recently, utilization of the colostomy site for laparoscopic reversal of Hartmann' s procedure was introduced, and several studies have shown the feasibility of the procedure. [1][2][3][4][5] It allows for the colostomy site as an access port for the operation. However, single port surgery is technically more challenging than multiport surgery due to instrument interference and inaccessible angles from a single site.…”

Section: Introductionmentioning

confidence: 99%

Reduced Port Laparoscopic Reversal of Hartmann’s Procedure Using the Colostomy Site

Kim

Son

et al. 2016

J Minim Invasive Surg

View full text Add to dashboard Cite

show abstract

Single-Incision Laparoscopic Reversal of Hartmann Procedure via the Colostomy Site Only

Abstract: 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.

Cited by 15 publications

References 10 publications

The Evolution of Minimally Invasive Techniques in Restoration of Colonic Continuity

The Evolution of Minimally Invasive Techniques in Restoration of Colonic Continuity

Single‐incision laparoscopic reversal of Hartmann's operation through the stoma site: comparative outcomes with conventional laparoscopic and open surgery

Reduced Port Laparoscopic Reversal of Hartmann’s Procedure Using the Colostomy Site

Contact Info

Product

Resources

About