Hartmann’s Procedure
A Hartmann’s procedure is a type of bowel surgery in which a diseased portion of the colon (usually the sigmoid colon) is removed, and the end of the healthy colon is brought out through the abdominal wall as a colostomy. The rectal stump (the remaining part of the rectum) is closed off and left inside the abdomen.
This operation is often performed in emergency or high-risk situations where it's not safe to immediately reconnect the bowel.
What Happens During the Procedure:
- The diseased section of the sigmoid colon is removed.
- The top end of the colon is brought out through the abdominal wall to create a colostomy (an opening called a stoma).
- The lower end (rectal stump) is sutured or stapled closed and left in the pelvis.
No immediate reconnection of the bowel is attempted.
After the Procedure:
- The colostomy allows stool to exit the body into a colostomy bag.
- Recovery depends on the patient’s condition and the reason for surgery (typically 7–14 days in hospital for major cases).
- Hartmann’s reversal (reconnecting the bowel and closing the stoma) may be performed months later, but not all patients are candidates.
Hartmann’s Reversal:
- This is a second surgery to rejoin the bowel and close the colostomy.
- It carries a risk of complications and is not always possible, especially in elderly or frail patients.
- Some patients may need a permanent colostomy.
