Laparoscopically Assisted Hartmann's Procedure Followed by Laparoscopic Reversal in a Patient with Peritonitis Induced by Colonic Perforation / 대한내시경복강경외과학회지

ABSTRACT

Although laparoscopic surgery has been adopted for the treatment of peritonitis since the time laparoscopy was introduced for emergency operations, a laparoscopic Hartmann's procedure has not been described. We report on a Hartmann's procedure and its reversal for the treatment of peritonitis from colonic perforation by laparoscopic surgery. A 43-year-old female was diagnosed with fecal peritonitis due to a colonic perforation in the rectosigmoid colon. Five trocars were used and a Lapdisc(R) (Hakko medical, Japan) was placed at the previous Phannelstiel incision site. One hundred sixty minutes were needed for the laparoscopic Hartmann's procedure following peritoneal lavage. An oral diet was started at the postoperative 6th day and the patient was discharged on the 20th day with complete recovery. Hartmann's reversal was laparoscopically performed 3 months later. A Lapdisc was placed at the colostomy site following colostomy take-down. Four trocars were inserted at the same area as the first operation. The operative time was 180 minutes. There were no postoperative complications.