Hartmann’s procedure

The surgical resection of the rectosigmoid colon with closure of the rectal stump and formation of an end colostomy.

It is used to treat colon cancer or diverticulitis.

Use is limited to emergency surgery when immediate anastomosis is not possible, or more rarely it is used palliatively in colorectal tumors.

The procedure with a proximal end colostomy or ileostomy is the most common operation carried out by general surgeons for management of malignant obstruction of the distal colon.

During the procedure, the lesion is removed, the distal bowel closed intraperitoneally, and the proximal bowel diverted with a stoma.

Indications for this procedure include:
a. Localized or generalized peritonitis caused by perforation of the bowel secondary to cancer, or diverticulitis.
b. Viable but injured proximal bowel that precludes safe anastomosis.

Associated with a low perioperative mortality of 9%.

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