GASLESS VIDEO-ASSISTED REVERSAL OF HARTMANN PROCEDURE

More than 60% of patients who are submitted to Hartmann's procedure re fuse to undergo reversal. This authors suggest a minimally invasive ap proach without pneumoperitoneum. A consecutive series of four male pat ients, average age 64 years, underwent lapaproscopic assisted reversal of Hartmann's procedure in our department. The procedure was performe d for intestinal malignant occlusion in two cases and for perforated d iverticulitis in the other two. Mobilization was nearly immediate and incisional pain almost absent; peristalsis restarted after 36-48 h. Fi nally, the patients were discharged on day 6. Neither mortality nor mo rbidity occurred in the 8-month follow up period. The authors conclude that this new laparoscopic procedure may lead to shorter hospital sta ys and increased acceptance by patients, while maintaining the same sa fety of the traditional open procedure.