Reversal of Hartmann’s Procedure

Typically, reversal of a Hartmann’s procedure is performed 3–6 months following colostomy creation. This interlude allows for the patient’s overall condition to improve, bowel edema to subside, and wounds to heal. This procedure involves restoration of bowel continuity by anastomosis of the colostomy to the Hartmann’s pouch. A temporary loop ileostomy may be fashioned if the bowel quality or anastomosis is questionable. This chapter describes indications, essential steps, variations, and complications of this procedure. It provides a detailed template operative note for the procedure.